Provider Demographics
NPI:1689657074
Name:VISITING NURSE ASSOCIATION AND HOSPICE OF NE OHIO
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION AND HOSPICE OF NE OHIO
Other - Org Name:FORUM HEALTH AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINIC
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN,
Authorized Official - Phone:330-884-2500
Mailing Address - Street 1:3530 BELMONT AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1400
Mailing Address - Country:US
Mailing Address - Phone:330-884-2500
Mailing Address - Fax:330-884-2550
Practice Address - Street 1:3530 BELMONT AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1400
Practice Address - Country:US
Practice Address - Phone:330-884-2500
Practice Address - Fax:330-884-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9072453Medicaid
OH367061Medicare ID - Type Unspecified