Provider Demographics
NPI:1841609328
Name:ASHTABULA COUNTY COMMUNITY ACTION AGENCY
Entity Type:Organization
Organization Name:ASHTABULA COUNTY COMMUNITY ACTION AGENCY
Other - Org Name:ASHTABULA COUNTY COMMUNITY ACTION AGENCY SPEECH & AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRUNAUER-SETTLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-993-7716
Mailing Address - Street 1:4510 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6925
Mailing Address - Country:US
Mailing Address - Phone:440-993-7716
Mailing Address - Fax:440-992-3319
Practice Address - Street 1:4200 STATE RD
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6017
Practice Address - Country:US
Practice Address - Phone:440-993-7716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech