Provider Demographics
NPI:1619172442
Name:SOUTHERN OHIO COUNCIL OF GOVERNMENT
Entity Type:Organization
Organization Name:SOUTHERN OHIO COUNCIL OF GOVERNMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-775-5030
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-0456
Mailing Address - Country:US
Mailing Address - Phone:740-775-5030
Mailing Address - Fax:740-775-5023
Practice Address - Street 1:27 W 2ND ST STE 202
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3111
Practice Address - Country:US
Practice Address - Phone:740-775-5030
Practice Address - Fax:740-775-5023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2233103Medicaid