Provider Demographics
NPI:1568687622
Name:BELMONT COUNTY BOARD OF DEVELOPMENT DISABILITIES
Entity Type:Organization
Organization Name:BELMONT COUNTY BOARD OF DEVELOPMENT DISABILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LLEWELLYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-695-0407
Mailing Address - Street 1:68421 HAMMOND ROAD
Mailing Address - Street 2:
Mailing Address - City:ST. CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8783
Mailing Address - Country:US
Mailing Address - Phone:740-695-0407
Mailing Address - Fax:740-695-7427
Practice Address - Street 1:68421 HAMMOND ROAD
Practice Address - Street 2:
Practice Address - City:ST. CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8783
Practice Address - Country:US
Practice Address - Phone:740-695-0407
Practice Address - Fax:740-695-7427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH777039Medicaid