Provider Demographics
NPI:1669917043
Name:LIMA UMADAOP
Entity type:Organization
Organization Name:LIMA UMADAOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRTLE
Authorized Official - Middle Name:BOYKIN
Authorized Official - Last Name:LIGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-222-4474
Mailing Address - Street 1:311 E MARKET ST
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4535
Mailing Address - Country:US
Mailing Address - Phone:419-222-4474
Mailing Address - Fax:
Practice Address - Street 1:3491 STATE ROUTE 108
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-9410
Practice Address - Country:US
Practice Address - Phone:419-335-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161551251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management