Provider Demographics
NPI:1235342858
Name:GUERNSEY COUNTY SENIOR CITIZENS CENTER, INC.
Entity type:Organization
Organization Name:GUERNSEY COUNTY SENIOR CITIZENS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHON
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-439-6681
Mailing Address - Street 1:1022 CARLISLE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2420
Mailing Address - Country:US
Mailing Address - Phone:740-439-6681
Mailing Address - Fax:740-439-7478
Practice Address - Street 1:1022 CARLISLE AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2420
Practice Address - Country:US
Practice Address - Phone:740-439-6681
Practice Address - Fax:740-439-7478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0808237Medicaid