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General NPI Number Information
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NPI Number | 1316810427
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Entity Type | Organization
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Legal Business Name | AKRON ASHTABULA CLEVE BAPTIST ASSN CAMP KOINONIA
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 6810 CORK COLD SPRINGS RD
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City | GENEVA
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State | OH
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Zip | 44041-9346
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Country | US
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Telephone | 440-466-1278
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Fax |
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Provider Business Mailing Address
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Address Line | 6810 CORK COLD SPRINGS RD
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City | GENEVA
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State | OH
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Zip | 44041-9346
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Country | US
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Telephone | 440-466-1278
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/DISABILITY S
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Name | ANGELINA GILL
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Credential | OTR/L
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Telephone | 440-812-1787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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