Ohio Medicaid Provider - Dayton, OH

Ohio Medicaid Provider

Adult Care Home Facility in Dayton, Ohio

NPI 1659555407

Ohio Medicaid Provider is an Adult Care Home Facility based in Dayton, OH and is specialized in Adult Care Home. Ohio Medicaid Provider practices in Dayton, OH. The NPI Number for Ohio Medicaid Provider is 1659555407 and holds a License No. PN0830007 (Ohio).

The current practice location address for Ohio Medicaid Provider is 322 Albers Ave, Dayton, OH and can be reached out via phone at 937-479-1676. You can also correspond with Ohio Medicaid Provider through the mailing address at 322 ALBERS AVE, DAYTON, OH - 45427-1703 (mailing address contact number: ).

Location: 322 Albers Ave, Dayton, OH, 45427-1703

NPI Number

1659555407

Provider Name

Ohio Medicaid Provider

Credential

Provider Entity Type

Organization

Address

322 Albers Ave, Dayton, OH, 45427-1703

Phone Number

937-479-1676

Fax Number

Provider Enumeration Date

12/27/2007

Last Update Date

03/09/2024

Identifier	Type	State	Issuer
2516950	05	OH

Address

322 Albers Ave

City

Dayton

State

Ohio

Zip

45427-1703

Phone Number

937-479-1676

Fax Number

Address

322 Albers Ave

City

Dayton

State

Ohio

Zip

45427-1703

Phone Number

Fax Number

Type

Nursing & Custodial Care Facilities

Classification

Custodial Care Facility

Speciality

Adult Care Home

Taxonomy

311ZA0620X

License No.

PN0830007 (Ohio)

Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

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