Provider Demographics
NPI:1841432838
Name:PARAMOUNT SUPPORT SERVICES OF ST. CLAIRSVILLE, OHIO, INC
Entity type:Organization
Organization Name:PARAMOUNT SUPPORT SERVICES OF ST. CLAIRSVILLE, OHIO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-526-0540
Mailing Address - Street 1:68138 VINEYARD RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8421
Mailing Address - Country:US
Mailing Address - Phone:740-526-0540
Mailing Address - Fax:740-526-0541
Practice Address - Street 1:68138 VINEYARD RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8421
Practice Address - Country:US
Practice Address - Phone:740-526-0540
Practice Address - Fax:740-526-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2601054Medicaid
OH0700576OtherOHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES