Ohio Medicaid Provider in Dayton - Adult Care Home
Ohio Medicaid Provider - NPI 1659555407
Ohio Medicaid Provider is a Adult Care Home in Dayton, Ohio. Ohio Medicaid Provider practices all healthcare services and medical treatments related to Adult Care Home. The NPI Number for Ohio Medicaid Provider is 1659555407. The last update date is 2007-12-27.
Ohio Medicaid Provider's current location address is 322 Albers Ave, Dayton, Ohio. You can contact this provider via phone number 9374791676. The mailing address for Ohio Medicaid Provider is 322 Albers Ave, Dayton, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Ohio Medicaid Provider |
|---|---|
| Address | 322 Albers Ave, Dayton, Ohio |
| Phone Number | 9374791676 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | LPN |
|---|---|
| Authorized Official Name | Ballard Lee Saundra |
| Credentials | LPN |
| Telephone Number | 9374791676 |
NPI Number Detail
| NPI Number | 1659555407 |
|---|---|
| Provider Enumeration Date | 2007-12-27 |
| Last Updated Date | 2007-12-27 |
Provider Mailing Address Detail
| Address | 322 Albers Ave |
|---|---|
| City | Dayton |
| State | Ohio (OH) |
| Post Code | 454271703 |
| Phone Number | 9374791676 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Adult Care Home |
|---|---|
| Taxonomy | 311Za0620X |
| Licence No | PN0830007 |
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Definition: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like en |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2516950 | OH | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Ohio Medicaid Provider by the Centers for Medicare & Medicaid Services?
The Ohio Medicaid Provider has been assigned the NPI (National Provider Identifier) 1659555407 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Ohio Medicaid Provider's facilities are situated?
The facilities of Ohio Medicaid Provider are physically located at the following address: 322 Albers Ave, Dayton, OH, 454271703.
What is Ohio Medicaid Provider's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Ohio Medicaid Provider is Adult Care Home, and the corresponding taxonomy classification code for this specialized field is 311Za0620X.
On what date did the Ohio Medicaid Provider receive its 1659555407 assignment from the Centers for Medicare & Medicaid Services?
The Ohio Medicaid Provider was assigned its 1659555407 by the Centers for Medicare & Medicaid Services on 2007-12-27.
As of what date were the details related to Ohio Medicaid Provider most recently updated or revised?
The information pertaining to Ohio Medicaid Provider, including its address, specialty, and other relevant details, was last updated or revised on 2007-12-27.
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