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Organization

ASHTABULA COUNTY COMMUNITY ACTION AGENCY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIANA BROOK (HEALTH & NUTRITION SERVICE DIRECTOR)
(440) 998-7515
Entity
Organization

Contact information

Practice address
4200 STATE RD, ASHTABULA, OH 44004-6017
(440) 998-7515
(440) 998-0973
Mailing address
4200 STATE RD, ASHTABULA, OH 44004-6017
(440) 998-7515
(440) 998-0973

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0412486
OH
Enumeration date
05/22/2007
Last updated
06/08/2021
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