Provider Demographics
NPI:1306225610
Name:NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.
Entity Type:Organization
Organization Name:NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.
Other - Org Name:HOLLAND HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLER-CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-720-7883
Mailing Address - Street 1:313 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1004
Mailing Address - Country:US
Mailing Address - Phone:419-720-7883
Mailing Address - Fax:419-720-7895
Practice Address - Street 1:225 N IRWIN RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9745
Practice Address - Country:US
Practice Address - Phone:419-255-7883
Practice Address - Fax:419-720-7895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0132962Medicaid
OH361086Medicare Oscar/Certification