1316154263 NPI number — THE SALVATION ARMY

Table of content: (NPI 1316154263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316154263 NPI number — THE SALVATION ARMY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE SALVATION ARMY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE SAMARITAN CENTER FOR ADULT CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316154263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX C-635
Provider Second Line Business Mailing Address:
440 WEST NYACK ROAD
Provider Business Mailing Address City Name:
WEST NYACK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10994-1739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-620-7330
Provider Business Mailing Address Fax Number:
845-620-7753

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
228 W HUBERT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43130-4712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-687-1921
Provider Business Practice Location Address Fax Number:
740-687-1928
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
D
Authorized Official Title or Position:
ASSISTANT SECRETARY
Authorized Official Telephone Number:
845-620-7330

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0790461 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2677616 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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