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General NPI Number Information
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NPI Number | 1851461644
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Entity Type | Organization
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Legal Business Name | IRONTON & LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 223 CARLTON DAVIDSON LN
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City | COAL GROVE
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State | OH
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Zip | 45638-2924
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Country | US
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Telephone | 740-532-3048
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Fax | 740-532-0319
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Provider Business Mailing Address
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Address Line | 305 N 5TH ST
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City | IRONTON
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State | OH
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Zip | 45638-1578
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Country | US
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Telephone | 740-532-3534
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Fax | 740-532-0027
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Authorized Official
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Title or Position | DIRECTOR OF HEALTH SERVICES
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Name | MRS. NANCY J LEWIS
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Credential | CPNP
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Telephone | 740-532-3534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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