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NPI Code Detail

MEDICARE: ANTONINE SISTERS ADULT DAY CARE, INC.

MEDICARE: ANTONINE SISTERS ADULT DAY CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA0600XAdult Day Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851509665
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANTONINE SISTERS ADULT DAY CARE, INC.
Provider Business Mailing Address
First Line : 2675 N LIPKEY RD
Second Line :
City : NORTH JACKSON
State : OH
Zip : 44451-9665
Country : US
Telephone Number : 330-538-9822
Fax Number : 330-538-9820
Provider Business Practice Location Address
First Line : 2675 N LIPKEY RD
Second Line :
City : NORTH JACKSON
State : OH
Zip : 44451-9665
Country : US
Telephone Number : 330-538-9822
Fax Number : 330-538-9820
Authorized Official
Title or Position : DIRECTOR
Name : MARIE MADELEINE ISKANDAR
Credential :
Telephone Number : 330-538-9822
Provider Enumeration Date : 05/18/2007
Last Update Date : 06/16/2008

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Directions to “ANTONINE SISTERS ADULT DAY CARE, INC. ” Practice Location

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