Provider Demographics
NPI:1619604840
Name:CARROLL COUNTY COUNCIL FOR AGING
Entity Type:Organization
Organization Name:CARROLL COUNTY COUNCIL FOR AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:AUKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-627-7017
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-0014
Mailing Address - Country:US
Mailing Address - Phone:330-627-7017
Mailing Address - Fax:330-476-6402
Practice Address - Street 1:100 KENSINGTON RD NE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-9499
Practice Address - Country:US
Practice Address - Phone:330-627-7017
Practice Address - Fax:330-476-6402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0811330Medicaid