DEPARTMENT OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES (NPI# 1174670285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174670285 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES |
| Practice Address |
1601 W Broad St Columbus OH 43222-1054 |
| Mailing Address |
30 E Broad St Columbus OH 43215-3414 |
| Practice Telephone | 6142720509 |
| Practice Fax Number | 6142721054 |
| Mailing Telephone | 6144661970 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2008-12-05 |
| Authorized Official Name | D MICHAEL SNOW (SUPERINTENDENT) |
| Authorized Official Telephone | 6142720509 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2514097 | OH | Residential Treatment Facilities |
| N | 310500000X | Intermediate Care Facility, Mental Illness | 2514097 | OH | Nursing & Custodial Care Facilities |
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 2514097 | OH | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2438080 | 05 |
| Street Address |
1601 W BROAD ST |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43222-1054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841279395 | Remus Nervez | Family Medicine | 1601 W Broad St, Columbus, OH 43222-1054 | 2006-01-12 |
| 1710594189 | Roxanne Ingrid Cooley | Homemaker | 1601 W Broad St, Columbus, OH 43222-1054 | 2020-09-29 |
| 1083221469 | Teresa Brown | Homemaker | 1601 W Broad St, Columbus, OH 43222-1054 | 2020-09-29 |
| 1083257604 | Bonetta Lou Coulter | Clinical Nurse Specialist | 1601 W Broad St, Columbus, OH 43222-1054 | 2019-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447893284 | Columbus Neighborhood Health Center, Inc. Dba Primaryone Health | Clinic/Center | 730 W. Town Street, Columbus, OH 43222 | 2019-10-24 |
| 1760037006 | New Hope Behavioral Health, LLC | Counselor | 775 W. Broad St., Suite 210, Columbus, OH 43222 | 2019-08-05 |
| 1649623208 | Carol Leslie Eppler | Social Worker | 1251 W. Broad St, Maryhaven@lower Lights Christian Health Center, Columbus, OH 43222 | 2016-07-19 |
| 1457770471 | Hareesh Venkata Singam | Student in an Organized Health Care Education/Training Program | 793 W. State St., Columbus, OH 43222 | 2014-04-08 |
| 1629243373 | Jeffrey Eric Salon | Internal Medicine | 745 West State, Suite 610, Columbus, OH 43222 | 2008-04-24 |
| 1821110693 | Ashita Sinha | Hospitalist | 793 W.state St., Mount Carmel Hospital ( Columbus Inpatient Care Group), Columbus, OH 43222 | 2007-04-04 |
| 1124194204 | Mary Elizabeth Sparks | Social Worker | 1810 Sullivant Ave, Columbus, OH 43222 | 2006-11-28 |
| 1437222346 | Brandie M Price | Registered Nurse | 793 West State St, Columbus, OH 43222 | 2006-11-16 |
| 1467535641 | Bernard Andrew Bronczyk | Family Medicine | 1601 W Broad, Columbus, OH 43222 | 2006-10-23 |
| 1245328251 | Neil Alan Miller | Registered Nurse | 793 W State Street, Mt Carmel Medical Center, Columbus, OH 43222 | 2006-10-11 |
| Find all providers in zip 43222 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053865568 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 2433 Teakwood Dr, Columbus, OH 43229-9328 | 2016-08-12 |
| 1386197929 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 1382 Ida Ave, Columbus, OH 43212-2908 | 2016-08-01 |
| 1053864694 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 4171 Maize Rd, Columbus, OH 43224-1951 | 2016-08-01 |
| 1376096909 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 2357 Hampstead Dr, Columbus, OH 43229-2852 | 2016-08-01 |
| 1619420254 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 3860 Kimberly Pkwy N, Columbus, OH 43232-4267 | 2016-08-01 |
| 1265629448 | Voca Corporation of Ohio | Intermediate Care Facility, Mentally Retarded | 340 Derrer Rd, Columbus, OH 43204-1127 | 2007-10-01 |
| 1114127743 | Rescare Ohio Inc.. | Intermediate Care Facility, Mentally Retarded | 4133 Karl Rd, Columbus, OH 43224-2054 | 2007-07-22 |
| 1881802254 | Franklin County Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 4410 Morse Rd, Columbus, OH 43230-1382 | 2007-05-18 |
| 1174731996 | Residential Options, Inc | Intermediate Care Facility, Mentally Retarded | 3273 Shasta Ave, Columbus, OH 43231-3160 | 2007-05-18 |
| 1578771911 | Franklin County Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 5684 Dierker Rd, Columbus, OH 43235-7114 | 2007-05-18 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.