Provider Demographics
NPI:1841580719
Name:SOCIETY FOR HANDICAPPED CITIZENS
Entity Type:Organization
Organization Name:SOCIETY FOR HANDICAPPED CITIZENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-722-1900
Mailing Address - Street 1:4283 PARADISE RD
Mailing Address - Street 2:
Mailing Address - City:SEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44273-9353
Mailing Address - Country:US
Mailing Address - Phone:330-722-1900
Mailing Address - Fax:330-723-6695
Practice Address - Street 1:4283 PARADISE RD
Practice Address - Street 2:
Practice Address - City:SEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44273-9353
Practice Address - Country:US
Practice Address - Phone:330-722-1900
Practice Address - Fax:330-723-6695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5210373320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3107748Medicaid