Provider Demographics
NPI:1952317638
Name:AIDS RESOURCE CENTER OHIO INC.
Entity Type:Organization
Organization Name:AIDS RESOURCE CENTER OHIO INC.
Other - Org Name:COLUMBUS AIDS TASK FORCE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:614-340-6691
Mailing Address - Street 1:4400 N. HIGH STREET
Mailing Address - Street 2:STE 300
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2635
Mailing Address - Country:US
Mailing Address - Phone:614-299-2437
Mailing Address - Fax:614-340-6787
Practice Address - Street 1:4400 N. HIGH STREET
Practice Address - Street 2:STE 300
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2635
Practice Address - Country:US
Practice Address - Phone:614-299-2437
Practice Address - Fax:614-340-6787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08490251B00000X
OH0667251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8490Medicaid