Provider Demographics
NPI:1992829899
Name:ALLEN COUNTY BOARD OF MRDD
Entity Type:Organization
Organization Name:ALLEN COUNTY BOARD OF MRDD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:NANCE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:419-221-1385
Mailing Address - Street 1:2500 ADA RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3340
Mailing Address - Country:US
Mailing Address - Phone:419-221-1385
Mailing Address - Fax:419-221-1296
Practice Address - Street 1:2500 ADA RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3340
Practice Address - Country:US
Practice Address - Phone:419-221-1385
Practice Address - Fax:419-221-1296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-17
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
Not Answered251S00000XAgenciesCommunity/Behavioral Health