Provider Demographics
NPI:1548159809
Name:EASTERSEALS NORTHWEST OHIO INC.
Entity type:Organization
Organization Name:EASTERSEALS NORTHWEST OHIO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ELBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-969-4241
Mailing Address - Street 1:4919 COLDWATER RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-5532
Mailing Address - Country:US
Mailing Address - Phone:260-456-4534
Mailing Address - Fax:260-745-5200
Practice Address - Street 1:1616 E WOOSTER ST STE 28
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-3466
Practice Address - Country:US
Practice Address - Phone:419-386-5693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child