# JACKSON-VINTON COMMUNITY ACTION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831134501
- **Authorized official:** MRS. CHERYL THIESSEN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (740) 384-3722

## Contact information

- **Practice address:** 118 S NEW YORK AVE, WELLSTON, OH 45692-1540
- **Practice address phone:** (740) 384-3722
- **Practice address fax:** (740) 384-5405
- **Mailing address:** 118 S NEW YORK AVE, WELLSTON, OH 45692-1540
- **Mailing address phone:** (740) 384-3722
- **Mailing address fax:** (740) 384-5405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 08/22/2020