Provider Demographics
NPI:1245376367
Name:UNITED METHODIST CHILDREN'S HOME OF THE WEST OHIO CONFERENCE OF THE UN
Entity type:Organization
Organization Name:UNITED METHODIST CHILDREN'S HOME OF THE WEST OHIO CONFERENCE OF THE UN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-885-5020
Mailing Address - Street 1:1033 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4026
Mailing Address - Country:US
Mailing Address - Phone:614-885-5020
Mailing Address - Fax:614-885-4058
Practice Address - Street 1:1033 HIGH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4026
Practice Address - Country:US
Practice Address - Phone:614-885-5020
Practice Address - Fax:614-885-4058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Not Answered320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Not Answered323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Not Answered385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11028Medicaid