Organization
LAWRENCE COUNTY BOARD OF MENTAL RETARDATION DEVELOPMENT DISABILITIES
Active
Organization
LAWRENCE COUNTY BOARD OF MENTAL RETARDATION DEVELOPMENT DISABILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL B. MOLLETT (SUPERINTENDENT)
(740) 532-7401
Entity
Organization
Contact information
Practice address
604 CARLTON DAVIDSON LN, COAL GROVE, OH 45638-2926
(740) 532-7401
Mailing address
604 CARLTON DAVIDSON LN, COAL GROVE, OH 45638-2926
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
0773042
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0642399
—
OH
Enumeration date
05/20/2007
Last updated
04/07/2009
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