Provider Demographics
NPI:1881675866
Name:CHN LLC ADULT DAY CARE
Entity Type:Organization
Organization Name:CHN LLC ADULT DAY CARE
Other - Org Name:COMPREHENSIVE HEALTH NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-548-0506
Mailing Address - Street 1:5420 STATE ROUTE 571
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-9606
Mailing Address - Country:US
Mailing Address - Phone:937-548-0506
Mailing Address - Fax:937-548-3468
Practice Address - Street 1:5420 STATE ROUTE 571
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-9606
Practice Address - Country:US
Practice Address - Phone:937-548-0506
Practice Address - Fax:937-548-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH367444Medicaid
OH2309648OtherMEDICAID SUPPLIES
OH1881675866OtherNPI
OH000000003144OtherANTHEM B/C BLUE SHIELD
OH0745288Medicaid
OH0790514OtherWAIVER IV