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Organization
MONTGOMERY DEVELOPMENTAL CENTER
Active
Organization
MONTGOMERY DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG A CARTER (BUSINESS ADMINISTRATOR)
(937) 233-8108
Entity
Organization
Contact information
Practice address
7650 TIMBERCREST DR, HUBER HEIGHTS, OH 45424-2405
(937) 233-8108
(937) 233-1477
Mailing address
7650 TIMBERCREST DR, HUBER HEIGHTS, OH 45424-2405
(937) 233-8108
(937) 233-1477
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2411278
—
OH
Enumeration date
12/29/2006
Last updated
08/11/2010
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