Provider Demographics
NPI:1760989404
Name:COMMUNITY ACTION ORGANIZATION OF SCIOTO COUNTY, INC.
Entity Type:Organization
Organization Name:COMMUNITY ACTION ORGANIZATION OF SCIOTO COUNTY, INC.
Other - Org Name:CAO OF SCIOTO COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:LUANNE
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-354-7541
Mailing Address - Street 1:PO BOX 1525
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-1525
Mailing Address - Country:US
Mailing Address - Phone:740-351-1188
Mailing Address - Fax:740-351-0567
Practice Address - Street 1:433 3RD ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3811
Practice Address - Country:US
Practice Address - Phone:740-354-7545
Practice Address - Fax:740-351-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-10
Last Update Date:2018-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1200442SUPV101YA0400X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0275108Medicaid