OrganizationActive
Clark County
NPI 1174797450 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Springfield, OH
Provider details
- NPI number
- 1174797450
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Ravi Shankar, Comptroller(937) 328-4626
- License
- 0888848 (OH)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 0888848 (OH)
Residential Treatment Facilities
Practice location
2527 Kenton St
Springfield, OH 45505-3352
Phone: (937) 328-2675
Fax: (937) 328-4625
Approximate (ZIP-level) locationGet directions
Mailing address
2527 Kenton St
Springfield, OH 45505-3352
Other names (DBA / former)
- Doing business as
- Clark County Board of Mr/Dd Unit B Icfmr
Registry dates
- Enumerated
- 2008-04-17
- Last updated
- 2008-04-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.