Healthcare Provider Details

I. General information

NPI: 1124997051
Provider Name (Legal Business Name): ON-DECK ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5702 ANGOLA RD LOT 73
TOLEDO OH
43615-6343
US

IV. Provider business mailing address

5702 ANGOLA RD LOT 73
TOLEDO OH
43615-6343
US

V. Phone/Fax

Practice location:
  • Phone: 567-984-7391
  • Fax:
Mailing address:
  • Phone: 567-984-7391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA CUNNINGHAM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 419-297-1026