Healthcare Provider Details

I. General information

NPI: 1104664259
Provider Name (Legal Business Name): OHIO DISTRICT 5 AREA AGENCY ON AGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 PARK AVE W
ONTARIO OH
44906-1226
US

IV. Provider business mailing address

2131 PARK AVE W
ONTARIO OH
44906-1226
US

V. Phone/Fax

Practice location:
  • Phone: 419-524-4144
  • Fax: 419-522-9482
Mailing address:
  • Phone: 419-524-4144
  • Fax: 419-522-9482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DUANA MICHELLE PATTON
Title or Position: CEO
Credential: MBA
Phone: 419-564-3868