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LICKING COUNTY AGING PROGRAM INC. NPI 1275833428


NPI Information

NPI: 1275833428
Provider Name: LICKING COUNTY AGING PROGRAM, INC.
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

CLIA Number: 36D2120344

Address:
1058 E MAIN ST
NEWARK, OH
ZIP 43055
Phone: (740) 345-0821
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LICKING COUNTY AGING PROGRAM, INC. is an adult day care clinic center in Newark, OH. LICKING COUNTY AGING PROGRAM, INC. NPI is 1275833428. The provider is registered as an organization entity type.

The provider's business location address is:

1058 E MAIN ST
NEWARK, OH
ZIP 43055-940
Phone: (740) 345-0821

The provider's authorized official is Melissa Owens .
The authorized official title is Executive Director and has the following contact phone number (740) 345-0821.

The CLIA number assigned to this NPI record is 36D2120344 - other - county jail medical dept with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/21/2010 and was last updated on 2/6/2023.


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
1251E00000XHome HealthNo
2261QA0600XClinic/CenterAdult Day CareYes

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
10808406MEDICAIDOHIO

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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