OrganizationActive
Clark County
NPI 1922267053 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Springfield, OH
Provider details
- NPI number
- 1922267053
- 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
- 2814576 (OH)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 2814576 (OH)
Residential Treatment Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
2527 Kenton St
Springfield, OH 45505-3352
Phone: (937) 328-2675
Fax: (937) 328-4625
Street-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 Yellow Icf/Mr
Registry dates
- Enumerated
- 2008-06-04
- Last updated
- 2008-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.