Provider Demographics
NPI:1457956922
Name:OHIO VALLEY ADULT DAY SERVICES, LLC
Entity Type:Organization
Organization Name:OHIO VALLEY ADULT DAY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENSLEY BOGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:513-582-1392
Mailing Address - Street 1:411 APPLE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-7524
Mailing Address - Country:US
Mailing Address - Phone:513-582-1392
Mailing Address - Fax:937-356-3966
Practice Address - Street 1:411 APPLE ST
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-7524
Practice Address - Country:US
Practice Address - Phone:513-582-1392
Practice Address - Fax:937-356-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0089776Medicaid
OH0801092OtherDODD