Healthcare Provider Details

I. General information

NPI: 1316154263
Provider Name (Legal Business Name): THE SALVATION ARMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 05/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 W HUBERT AVE
LANCASTER OH
43130-4712
US

IV. Provider business mailing address

P.O. BOX C-635 440 WEST NYACK ROAD
WEST NYACK NY
10994-1739
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-1921
  • Fax: 740-687-1928
Mailing address:
  • Phone: 845-620-7330
  • Fax: 845-620-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD D ALLEN
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 845-620-7330