Provider Demographics
NPI:1598735235
Name:MULTI DEVELOPMENT SERVICES OF STARK COUNTY
Entity Type:Organization
Organization Name:MULTI DEVELOPMENT SERVICES OF STARK COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-471-9139
Mailing Address - Street 1:424 FULTON RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-2815
Mailing Address - Country:US
Mailing Address - Phone:330-471-9139
Mailing Address - Fax:330-471-9763
Practice Address - Street 1:618 FULTON RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-2947
Practice Address - Country:US
Practice Address - Phone:330-454-8401
Practice Address - Fax:330-471-9763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH114892OtherVENDOR NUMBER FOR ADAS