Provider Demographics
NPI:1902897176
Name:COMMUNITY ACTION PROGRAM CORP OF WASHINGTON-MORGAN COUNTIES, OHIO
Entity Type:Organization
Organization Name:COMMUNITY ACTION PROGRAM CORP OF WASHINGTON-MORGAN COUNTIES, OHIO
Other - Org Name:FAMILY HEALTH SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:BRIGHTBILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-373-3745
Mailing Address - Street 1:218 PUTNAM ST
Mailing Address - Street 2:P O BOX 144
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3014
Mailing Address - Country:US
Mailing Address - Phone:740-373-3745
Mailing Address - Fax:740-373-6775
Practice Address - Street 1:218 PUTNAM ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3014
Practice Address - Country:US
Practice Address - Phone:740-373-3745
Practice Address - Fax:740-373-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QA0005X
332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0421001Medicaid
OH0395773Medicaid
OH0225849Medicaid