Healthcare Provider Details

I. General information

NPI: 1902897176
Provider Name (Legal Business Name): COMMUNITY ACTION PROGRAM CORP OF WASHINGTON-MORGAN COUNTIES, OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 PUTNAM ST
MARIETTA OH
45750-3014
US

IV. Provider business mailing address

218 PUTNAM ST P O BOX 144
MARIETTA OH
45750-3014
US

V. Phone/Fax

Practice location:
  • Phone: 740-373-3745
  • Fax: 740-373-6775
Mailing address:
  • Phone: 740-373-3745
  • Fax: 740-373-6775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID EDWIN BRIGHTBILL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-373-3745