Provider Demographics
NPI:1821290099
Name:WILLIAMS COUNTY BOARD OF MRDD
Entity Type:Organization
Organization Name:WILLIAMS COUNTY BOARD OF MRDD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-485-8331
Mailing Address - Street 1:11246 STATE ROUTE 15
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:OH
Mailing Address - Zip Code:43543-9282
Mailing Address - Country:US
Mailing Address - Phone:419-485-8331
Mailing Address - Fax:419-485-5495
Practice Address - Street 1:11246 STATE ROUTE 15
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:OH
Practice Address - Zip Code:43543-9282
Practice Address - Country:US
Practice Address - Phone:419-485-8331
Practice Address - Fax:419-485-5495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services