Pike Adult Activities Dba Canal Industries

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

PIKE ADULT ACTIVITIES DBA CANAL INDUSTRIES

Practice address

301 Clough St
Waverly, OH 45690-1112

Phone

(740) 947-7502

Fax

(740) 947-2550

NPI assigned

Nov 19, 2020

Organization subpart

No

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

Authorized official

Name

Becky Stevens

Title

Administrative Director

Phone

(740) 947-7502

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1861095119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CLOUGH ST",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901112",
            "telephone_number": "740-947-7502",
            "fax_number": "740-947-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CLOUGH ST",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901112",
            "telephone_number": "740-947-7502",
            "fax_number": "740-947-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKE ADULT ACTIVITIES DBA CANAL INDUSTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "740-947-7502"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601538",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ali N Penn, CNP
• Ashley Taylor Pennington, CDCA, QMHS
• Paula Perkins
• Savannah Jo-Nicole Perkins
• Laura Nicole Pierce
• Pike Co
• Pike Co
• Pike Co
• Pike Co
• Pike Co Board of DD

• Adult Day Care Clinic/Center in Waverly, OH
• Providers in Waverly, 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 Nov 19, 2020; 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.