Provider Demographics
NPI:1689294779
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:COMPLIANCE & QUALITY IMPROVEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-296-8730
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:614-253-6100
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:2020-04-20
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1417282754Medicaid
OH1417282757Medicaid