Pamela D Davis

Individual provider Active NPI Developmentally Disabled Services Day Training Agency · Amanda, OH

NPI 1962005744 · NPPES record last updated Nov 16, 2020

Key facts

NPI
1962005744
Entity type
Individual (NPI type 1)
Primary specialty
Developmentally Disabled Services Day Training Agency 251C00000X
License
2456168 (OH)
Practice address
9186 Chillicothe Lancaster Rd SW
Amanda, OH 43102-9534
Phone
(614) 565-5733
NPI assigned
Nov 16, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2456168OHMDDevelopmentally Disabled Services Day Training Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 2456168 OH Yes

Addresses

Primary practice location

9186 Chillicothe Lancaster Rd SW
Amanda, OH 43102-9534

Mailing address

9186 Chillicothe Lancaster Rd SW
Amanda, OH 43102-9534
Phone (614) 565-5733

Other identifiers

IdentifierTypeStateIssuer
2456168MedicaidOH

Other providers in Amanda, OH

All providers in Amanda, OH · Developmentally Disabled Services Day Training Agency in Ohio

Sources for this page

Verify at the official NPI Registry.