Organization
GREENE COUNTY BOARD OF MRDD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C LAROCK (SUPERINTENDENT)
(937) 562-6500
Entity
Organization
Contact information
Practice address
245 N VALLEY RD, XENIA, OH 45385-9301
(937) 562-6500
(937) 562-6520
Mailing address
245 N VALLEY RD, XENIA, OH 45385-9301
(937) 562-6500
(937) 562-6520
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
776192
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
776192
—
OH
Enumeration date
04/04/2007
Last updated
08/22/2020
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