Healthcare Provider Details

I. General information

NPI: 1457545741
Provider Name (Legal Business Name): HENRY COUNTY SENIOR CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 ROHRS AVE
NAPOLEON OH
43545
US

IV. Provider business mailing address

203 ROHRS AVE
NAPOLEON OH
43545-2145
US

V. Phone/Fax

Practice location:
  • Phone: 419-599-5515
  • Fax: 419-599-5525
Mailing address:
  • Phone: 419-599-5155
  • Fax: 419-599-5525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: PENNI BOSTELMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 419-599-5515