Provider Demographics
NPI:1619295813
Name:CRAWFORD-MARION PREVENTION PROGRAMS
Entity Type:Organization
Organization Name:CRAWFORD-MARION PREVENTION PROGRAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-387-8531
Mailing Address - Street 1:142 S PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-3730
Mailing Address - Country:US
Mailing Address - Phone:740-387-8531
Mailing Address - Fax:740-382-0455
Practice Address - Street 1:142 S PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-3730
Practice Address - Country:US
Practice Address - Phone:740-387-8531
Practice Address - Fax:740-382-0455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)