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
Update your record
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