Provider Demographics
NPI:1518088822
Name:CITY OF NORWOOD
Entity Type:Organization
Organization Name:CITY OF NORWOOD
Other - Org Name:NORWOOD HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAAKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-458-4600
Mailing Address - Street 1:2059 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2633
Mailing Address - Country:US
Mailing Address - Phone:513-458-4600
Mailing Address - Fax:513-458-4606
Practice Address - Street 1:2059 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2633
Practice Address - Country:US
Practice Address - Phone:513-458-4600
Practice Address - Fax:513-458-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3-3102-0000-01251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0656099Medicaid
OH0656099Medicaid