Provider Demographics
NPI:1740743483
Name:VINTON INDUSTRIES, INC.
Entity Type:Organization
Organization Name:VINTON INDUSTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-486-7303
Mailing Address - Street 1:31385 STATE ROUTE 93
Mailing Address - Street 2:
Mailing Address - City:MCARTHUR
Mailing Address - State:OH
Mailing Address - Zip Code:45651
Mailing Address - Country:US
Mailing Address - Phone:740-486-7303
Mailing Address - Fax:
Practice Address - Street 1:31385 STATE ROUTE 93
Practice Address - Street 2:
Practice Address - City:MCARTHUR
Practice Address - State:OH
Practice Address - Zip Code:45651
Practice Address - Country:US
Practice Address - Phone:740-486-7303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094573Medicaid
OH8200931OtherOHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES