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CAMP COURAGEOUS INC. NPI 1134368335


NPI Information

NPI: 1134368335
Provider Name: CAMP COURAGEOUS, INC.
Classification: Respite Care - 385HR2050X
Entity Type: Organization

Specialization: Respite Care Camp

Address:
12701 WATERVILLE SWANTON RD
WHITEHOUSE, OH
ZIP 43571
Phone: (419) 875-6828
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CAMP COURAGEOUS, INC. is a respite care camp respite care in Whitehouse, OH. The provider is a camping facility that provides specialized respite care to individuals requiring enhanced services to enable them to remain in the community, (e.g., those with developmental delays, intellectual disabilities, mental/behavioral disorders). The staff must have training in working with the target populations and dealing with emergency situations which might be related to or exacerbate the individual's condition. CAMP COURAGEOUS, INC. NPI is 1134368335. The provider is registered as an organization entity type.

The provider's business location address is:

12701 WATERVILLE SWANTON RD
WHITEHOUSE, OH
ZIP 43571-551
Phone: (419) 875-6828
Fax: (419) 872-5598

The provider's authorized official is Steven Keissling .
The authorized official title is Director and has the following contact phone number (419) 875-6828.

The enumeration date for this NPI number is 2/11/2009 and was last updated on 3/4/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1385HR2050XRespite CareRespite Care CampYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12400306MEDICAIDOHIO
24801316OTHEROHIOODMRDD CONTRACT #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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