Healthcare Provider Details

I. General information

NPI: 1699431593
Provider Name (Legal Business Name): TRIANGULAR PROCESSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2021
Last Update Date: 11/15/2021
Certification Date: 11/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W LINFOOT ST
WAUSEON OH
43567-9559
US

IV. Provider business mailing address

550 W LINFOOT ST
WAUSEON OH
43567-9559
US

V. Phone/Fax

Practice location:
  • Phone: 419-337-9640
  • Fax:
Mailing address:
  • Phone: 419-337-9640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN SHAW
Title or Position: DIRECTOR
Credential:
Phone: 419-337-9640