Provider Demographics
NPI:1518580141
Name:VOLUNTEERS OF AMERICA OHIO & INDIANA
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA OHIO & INDIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW
Authorized Official - Prefix:
Authorized Official - First Name:LUANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LARUE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:419-563-7984
Mailing Address - Street 1:1776 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1787
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44902-7317
Practice Address - Country:US
Practice Address - Phone:419-525-4589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1629290861Medicaid