Organization
COMMUNITY CARE ON WHEELS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY MARIE JACOBS (PRESIDENT)
(330) 882-5506
Entity
Organization
Contact information
Practice address
60 KAUFFMANS CRK, CLINTON, OH 44216-8658
(330) 882-5506
(330) 882-5568
Mailing address
60 KAUFFMANS CRK, CLINTON, OH 44216-8658
(330) 882-5506
(330) 882-5568
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
765155
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2702436
WAIVER SERVICES
OH
Enumeration date
02/23/2007
Last updated
08/22/2020
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