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General NPI Number Information
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NPI Number | 1972501112
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Entity Type | Organization
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Legal Business Name | COLLEGE PARK INC
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 380 BROWNS LN SUITE 7
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City | COSHOCTON
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State | OH
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Zip | 43812-2073
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Country | US
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Telephone | 740-623-4607
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Fax | 740-623-4618
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Provider Business Mailing Address
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Address Line | 380 BROWNS LN SUITE 7
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City | COSHOCTON
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State | OH
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Zip | 43812-2073
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Country | US
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Telephone | 740-623-4607
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Fax | 740-623-4618
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TIMOTHY POSTLEWAITE
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Credential |
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Telephone | 740-623-4607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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