Licking County Aging Program, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

LICKING COUNTY AGING PROGRAM, INC.

Practice address

1058 E Main St
Newark, OH 43055-6940

Phone

(740) 345-0821

NPI assigned

Oct 21, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Melissa Owens, MBA

Title

Executive Director

Phone

(740) 345-0821

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1275833428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 E MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430556940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 E MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430556940",
            "telephone_number": "740-345-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICKING COUNTY AGING PROGRAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-345-0821",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0808406",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc J Lewis, D.D.S.
• Mary Rose Ashbrook Lewis, LSW
• Terrell Lewis
• Alexander Libertini
• Licking County
• Licking County Alcoholism Prevention Program
• Licking County Alcoholism Prevention Program
• Licking County Board of MRDD
• Licking County Board of MRDD
• Licking County Community Health Care

• Adult Day Care Clinic/Center in Newark, OH
• Providers in Newark, OH by specialty
• Adult Day Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.