Provider Demographics
NPI:1326311051
Name:COUNTRY NEIGHBOR PROGRAM, INC.
Entity Type:Organization
Organization Name:COUNTRY NEIGHBOR PROGRAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINGENSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-437-6311
Mailing Address - Street 1:39 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ORWELL
Mailing Address - State:OH
Mailing Address - Zip Code:44076-9501
Mailing Address - Country:US
Mailing Address - Phone:440-437-6311
Mailing Address - Fax:440-437-1031
Practice Address - Street 1:39 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:ORWELL
Practice Address - State:OH
Practice Address - Zip Code:44076-9501
Practice Address - Country:US
Practice Address - Phone:440-437-6311
Practice Address - Fax:440-437-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0809174Medicaid