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Contact Information

PORTAGE COUNTY BOARD OF DEVELOPMENTAL DISABILIT
7008 STATE ROUTE 88
RAVENNA, OH44266-9188
 Phone: 330-296-2839
 Fax: 330-297-8875
 Website:
Indicates primary specialty

NPI Profile & details for PORTAGE COUNTY BOARD OF DEVELOPMENTAL DISABILIT

NPI Number 1639164205
LBN Legal business name PORTAGE COUNTY BOARD OF DEVELOPMENTAL DISABILIT
Authorized official OMAR NAGI - (SUPERINTENDENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/20/2005
Last updated 09/22/2016 - About 10 years ago
Identifiers
OH License # 0776129
OH License # 2560072
OH Medicaid 6700010
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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