Provider Demographics
NPI:1861541039
Name:HIGHLAND COUNTY COMMUNITY ACTION ORGANIZATION
Entity type:Organization
Organization Name:HIGHLAND COUNTY COMMUNITY ACTION ORGANIZATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:193-739-3306
Mailing Address - Street 1:1487 N HIGH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-8496
Mailing Address - Country:US
Mailing Address - Phone:937-393-3458
Mailing Address - Fax:937-393-7707
Practice Address - Street 1:1487 NORTH HIGH STREET
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133
Practice Address - Country:US
Practice Address - Phone:937-393-3458
Practice Address - Fax:937-393-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2018-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0293516Medicaid