Organization
PIKE ADULT ACTIVITIES DBA CANAL INDUSTRIES
Active
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
Update your record
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