OrganizationActive
Department of Mental Retardation and Developmental Disabilities
NPI 1174670285 · Intellectual Disabilities Intermediate Care Facility · Columbus, OH
Provider details
- NPI number
- 1174670285
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- D Snow, Superintendent(614) 272-0509
- License
- 2514097 (OH)
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Intellectual and/or Developmental Disabilities Residential Treatment Facility320600000XLicense 2514097 (OH)
Residential Treatment Facilities
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1601 W Broad St
Columbus, OH 43222-1054
Phone: (614) 272-0509
Fax: (614) 272-1054
Street-level locationGet directions
Mailing address
30 E Broad St
Columbus, OH 43215-3414
Registry dates
- Enumerated
- 2007-01-04
- Last updated
- 2008-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.