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Active NPI 1497196513 Organization (Entity Type 2)

Potential Development Program

Local Education Agency (LEA) • Youngstown, OH

About Potential Development Program NPI 1497196513 Summary

Potential Development Program is a verified healthcare organization specializing in Local Education Agency (LEA) operating in Youngstown, OH. Located at POTENTIAL DEVELOPMENT PROGRAM, 2405 MARKET ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1497196513.

Administrative operations and authorized compliance are overseen by Michael Thomas (Treasurer).

Facility Location & Contact Primary Location

Facility Address

Potential Development Program
2405 Market St

Youngstown, OH 44507

Telephone 2348551278
Fax 3307464008

Authorized Official Information

Authorized Contact Name

MR. Michael Thomas

Title / Role

Treasurer

Official Telephone

2348551278

Facility Classifications & Specialties

Local Education Agency (LEA) Primary Taxonomy

NUCC Taxonomy Code: 251300000X

The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

8 Historical Events
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Updated Practice Location March 14, 2024

Registered at POTENTIAL DEVELOPMENT PROGRAM, 2405 MARKET ST, YOUNGSTOWN, OH 44507 (Tel: 2348551278)

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Updated Business Mailing Address March 14, 2024

Registered at POTENTIAL DEVELOPMENT PROGRAM, 2405 MARKET ST, YOUNGSTOWN, OH 44507 (Tel: 3307467641)

NPI Profile Active August 14, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location August 14, 2013

Registered at 209 W WOODLAND AVE, YOUNGSTOWN, OH 445021866 (Tel: 3307467641)

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Updated Business Mailing Address August 14, 2013

Registered at 209 W WOODLAND AVE, YOUNGSTOWN, OH 445021866 (Tel: 3307467641)

🏛️
Organization / Clinic Name Updated August 14, 2013

Operating as POTENTIAL DEVELOPMENT PROGRAM

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 14, 2013

Local Education Agency (LEA) (License #132878 in OH)

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Initial NPI Registration & Enumeration July 17, 2013

First registered as active Healthcare Organization in NPPES Database.

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NPI Organization Metadata

NPI Number: 1497196513
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: July 17, 2013
Last Update: March 14, 2024

Mailing Address

Potential Development Program, 2405 Market St

Youngstown, OH 44507

Phone: 3307467641

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.