Healthcare Provider Details

I. General information

NPI: 1821041401
Provider Name (Legal Business Name): COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7880 LINCOLE PL
LISBON OH
44432-8322
US

IV. Provider business mailing address

7880 LINCOLE PL
LISBON OH
44432-8322
US

V. Phone/Fax

Practice location:
  • Phone: 330-424-5686
  • Fax: 330-424-4012
Mailing address:
  • Phone: 330-424-5686
  • Fax: 330-424-4012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNA WONNER
Title or Position: COO
Credential:
Phone: 330-424-7221