Provider Demographics
NPI:1083829394
Name:COMMUNITY ACTION PROGRAM, INC. OF WESTERN IN
Entity Type:Organization
Organization Name:COMMUNITY ACTION PROGRAM, INC. OF WESTERN IN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:PROCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-793-4881
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47932-0188
Mailing Address - Country:US
Mailing Address - Phone:765-793-4881
Mailing Address - Fax:765-793-4884
Practice Address - Street 1:22 W 2ND ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:IN
Practice Address - Zip Code:47993-1118
Practice Address - Country:US
Practice Address - Phone:765-762-0420
Practice Address - Fax:765-762-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Not Answered376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty