Provider Demographics
NPI:1255609467
Name:SOLID ROCK ADULT DAY CENTER INC
Entity type:Organization
Organization Name:SOLID ROCK ADULT DAY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VONGUNTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-990-1777
Mailing Address - Street 1:10911 MARKET AVE NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7669
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:330-877-1996
Practice Address - Street 1:10911 MARKET AVE NW
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7669
Practice Address - Country:US
Practice Address - Phone:330-990-1777
Practice Address - Fax:330-877-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2043830261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care