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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