Provider Demographics
NPI:1053588483
Name:CRAWFORD COUNTY BOARD OF MRDD
Entity type:Organization
Organization Name:CRAWFORD COUNTY BOARD OF MRDD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:FROBOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-562-3321
Mailing Address - Street 1:1650 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-3344
Mailing Address - Country:US
Mailing Address - Phone:419-562-3321
Mailing Address - Fax:419-562-3176
Practice Address - Street 1:1650 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-3344
Practice Address - Country:US
Practice Address - Phone:419-562-3321
Practice Address - Fax:419-562-3176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management