Organization
GOODWILL INDUSTRIES OF SOUTHERN OHIO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MONTGOMERY (VOCATIONAL REHABILITATION MANAGER)
(740) 353-4394
Entity
Organization
Contact information
Practice address
324 CHILLICOTHE ST, PORTSMOUTH, OH 45662-4012
(740) 353-4394
(740) 353-5622
Mailing address
324 CHILLICOTHE ST, PORTSMOUTH, OH 45662-4012
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140817
—
OH
Enumeration date
01/30/2023
Last updated
01/30/2023
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