Healthcare Provider Details
I. General information
NPI: 1346557634
Provider Name (Legal Business Name): COMMUNITY ACTION PROGRAM CORP OF WASHINGTON/MORGAN COS.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/08/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
442 S MAIN ST
MALTA OH
43758
US
IV. Provider business mailing address
218 PUTNAM ST P.O. BOX 144
MARIETTA OH
45750-3014
US
V. Phone/Fax
- Phone: 740-962-5266
- Fax: 740-962-5888
- Phone: 740-373-3745
- Fax: 740-373-6775
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0005X |
| Taxonomy | Ambulatory Family Planning Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
EDWIN
BRIGHTBILL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-373-3745