Organization
FAIRFIELD COMMUNITY SUPPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HOAG (CEO)
(740) 216-4807
Entity
Organization
Contact information
Practice address
15663 STATE ROUTE 595, LOGAN, OH 43138-8850
(740) 216-4807
Mailing address
15663 STATE ROUTE 595, LOGAN, OH 43138-8850
(740) 216-4807
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0303222
—
OH
Enumeration date
09/11/2020
Last updated
09/11/2020
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