Organization
OHIO DEPARTMENT OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES
Active
Other names
Gallipolis Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN DAVIS (SUPERINTENDENT)
(740) 446-1642
Entity
Organization
Contact information
Practice address
2500 OHIO AVE, GALLIPOLIS, OH 45631-1656
(740) 446-1642
(740) 446-1341
Mailing address
30 E BROAD ST, COLUMBUS, OH 43215-3414
(614) 466-1970
(614) 466-3141
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136025
—
OH
05
—
0280799
—
OH
05
—
0372618
—
OH
Enumeration date
02/12/2007
Last updated
02/11/2009
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