Provider Demographics
NPI:1437277563
Name:HIGHLAND COUNTY BOARD OF DEVELOPMENTAL DISABILITIES
Entity Type:Organization
Organization Name:HIGHLAND COUNTY BOARD OF DEVELOPMENTAL DISABILITIES
Other - Org Name:HIGHLAND COUNTY BOARD OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILI
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:L
Authorized Official - Last Name:BIGGERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:937-393-4237
Mailing Address - Street 1:8919 US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-7107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8919 US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-7107
Practice Address - Country:US
Practice Address - Phone:937-393-4237
Practice Address - Fax:937-393-5871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3600017251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0810368Medicaid