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Organization

PIKE ADULT ACTIVITIES DBA CANAL INDUSTRIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BECKY STEVENS (ADMINISTRATIVE DIRECTOR)
(740) 947-7502
Entity
Organization

Contact information

Practice address
301 CLOUGH ST, WAVERLY, OH 45690-1112
(740) 947-7502
(740) 947-2550
Mailing address
301 CLOUGH ST, WAVERLY, OH 45690-1112
(740) 947-7502
(740) 947-2550

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
261QA0600X
Adult Day Care Clinic/Center
Primary
343900000X
Non-emergency Medical Transport (VAN)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6601538
OH
Enumeration date
11/19/2020
Last updated
11/19/2020
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