Provider Demographics
NPI:1821119264
Name:GUERNSEY COUNTY BOARD OF DD
Entity Type:Organization
Organization Name:GUERNSEY COUNTY BOARD OF DD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-439-4451
Mailing Address - Street 1:60770 SOUTHGATE RD
Mailing Address - Street 2:
Mailing Address - City:BYESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43723-9731
Mailing Address - Country:US
Mailing Address - Phone:740-439-4451
Mailing Address - Fax:740-439-7114
Practice Address - Street 1:60770 SOUTHGATE RD
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723-9731
Practice Address - Country:US
Practice Address - Phone:740-439-4451
Practice Address - Fax:740-439-7114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No347B00000XTransportation ServicesBus
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3000013Medicaid