# LAKE COUNTY AUDITOR

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Co Bd Mental Retardation/Developmental Disability
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649391590
- **Authorized official:** MS. ELFRIEDE ROMAN (SUPERINTENDENT)
- **Authorized official phone:** (440) 350-5100

## Contact information

- **Practice address:** 8121 DEEPWOOD BLVD LAKE COUNTY BOARD OF DD, BUILDING A1, MENTOR, OH 44060
- **Practice address phone:** (440) 350-5100
- **Practice address fax:** (440) 350-5290
- **Mailing address:** 8121 DEEPWOOD BLVD LAKE COUNTY BOARD OF DD, BUILDING A1, MENTOR, OH 44060
- **Mailing address phone:** (440) 350-5100
- **Mailing address fax:** (440) 350-5290

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 04/08/2021