Provider Demographics
NPI:1356564694
Name:MORGAN COUNTY BOARD OF MRDD
Entity type:Organization
Organization Name:MORGAN COUNTY BOARD OF MRDD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KISSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-960-4200
Mailing Address - Street 1:155 E MAIN ST RM 306
Mailing Address - Street 2:
Mailing Address - City:MCCONNELSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43756-1297
Mailing Address - Country:US
Mailing Address - Phone:740-962-4200
Mailing Address - Fax:740-962-4435
Practice Address - Street 1:900 S RIVERSIDE DR NE
Practice Address - Street 2:
Practice Address - City:MC CONNELSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43756-9102
Practice Address - Country:US
Practice Address - Phone:740-962-4200
Practice Address - Fax:740-962-4435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0840040Medicaid