Provider Demographics
NPI:1851428049
Name:CLINTON COUNTY BOARD OF MRDD
Entity type:Organization
Organization Name:CLINTON COUNTY BOARD OF MRDD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEARINGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-382-7519
Mailing Address - Street 1:4425 STATE ROUTE 730
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-8661
Mailing Address - Country:US
Mailing Address - Phone:937-382-7519
Mailing Address - Fax:
Practice Address - Street 1:4425 STATE ROUTE 730
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-8661
Practice Address - Country:US
Practice Address - Phone:937-382-7519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251B00000X
OH1400013251C00000X
347B00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1400013Medicaid
OH0776067Medicaid