Provider Demographics
NPI:1891822672
Name:EASTER SEAL SOCIETY OF NORTHWESTERN OHIO INC.
Entity Type:Organization
Organization Name:EASTER SEAL SOCIETY OF NORTHWESTERN OHIO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-277-7337
Mailing Address - Street 1:1909 N RIDGE RD E STE 6
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3379
Mailing Address - Country:US
Mailing Address - Phone:440-277-7337
Mailing Address - Fax:440-277-7337
Practice Address - Street 1:1909 N RIDGE RD E STE 6
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3379
Practice Address - Country:US
Practice Address - Phone:440-277-7337
Practice Address - Fax:440-277-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0622759Medicaid