Provider Demographics
NPI:1255322004
Name:FRIENDS HEALTH CARE ASSOCIATION, INC
Entity Type:Organization
Organization Name:FRIENDS HEALTH CARE ASSOCIATION, INC
Other - Org Name:FRIENDS CARE COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-767-7363
Mailing Address - Street 1:150 E HERMAN ST
Mailing Address - Street 2:
Mailing Address - City:YELLOW SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:45387-1601
Mailing Address - Country:US
Mailing Address - Phone:937-767-7363
Mailing Address - Fax:937-767-2333
Practice Address - Street 1:150 E HERMAN ST
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-1601
Practice Address - Country:US
Practice Address - Phone:937-767-7363
Practice Address - Fax:937-767-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5719310400000X
OH3100314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0438931Medicaid
365538Medicare ID - Type Unspecified