Provider Demographics
NPI:1215828124
Name:STATE OF OHIO DEPARTMENT OF HEALTH
Entity type:Organization
Organization Name:STATE OF OHIO DEPARTMENT OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAREL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-599-8804
Mailing Address - Street 1:444 CRANDALL AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1457
Mailing Address - Country:US
Mailing Address - Phone:330-599-8804
Mailing Address - Fax:330-599-8804
Practice Address - Street 1:444 CRANDALL AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1457
Practice Address - Country:US
Practice Address - Phone:330-599-8804
Practice Address - Fax:330-599-8804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health