Provider Demographics
NPI:1336369800
Name:MERCER COUNTY BOARD OF MRDD
Entity Type:Organization
Organization Name:MERCER COUNTY BOARD OF MRDD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:OVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-586-2369
Mailing Address - Street 1:PO BOX 137
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-0137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:419-586-6375
Practice Address - Street 1:4980 MUD PIKE
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822
Practice Address - Country:US
Practice Address - Phone:419-586-2369
Practice Address - Fax:419-586-6375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management