OHIO MEDICAID PROVIDER
NPI 1659555407
Custodial Care Facility - Adult Care Home in Dayton, OH

Q: What is Ohio Medicaid Provider's NPI number?

The NPI number for Ohio Medicaid Provider is 1659555407. It was assigned to this organization in the NPPES registry on December 27, 2007.

Q: What is Ohio Medicaid Provider's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Active since December 27, 2007

322 ALBERS AVE, DAYTON, OH 45427(937) 479-1676 Get Directions Write a Review

NPPES record last updated: December 27, 2007. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Ohio Medicaid Provider NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OHIO MEDICAID PROVIDER (NPI 1659555407) is a healthcare organization registered as an adult care home in Dayton, Ohio and active in the NPI registry since December 2007. The organization lists Saundra Lee Ballard, Lpn, as its authorized official.

NPPES Registry Identity

NPI1659555407

Entity TypeOrganization

Primary Taxonomy311ZA0620X

Legal Business NameOHIO MEDICAID PROVIDER

Location Address322 ALBERS AVEDayton, OH 45427-1703

Mailing Address322 Albers AveDayton, OH 45427-1703

Phone(937) 479-1676

Organization SubpartNo

Authorized OfficialSaundra Lee BallardLpn · (937) 479-1676

Enumeration DateDecember 27, 2007

✔ NPI 1659555407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities

Taxonomy Code311ZA0620X

License✔ Licensed in OH · PN0830007

Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

322 ALBERS AVE, Dayton, OH 45427

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Other Identifiers 1

Medicaid2516950OH

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ohio Medicaid Provider's NPI number?

The NPI number for Ohio Medicaid Provider is 1659555407. It was assigned to this organization in the NPPES registry on December 27, 2007.

Where is Ohio Medicaid Provider located?

Ohio Medicaid Provider is located at 322 Albers Ave, Dayton, OH 45427. The listed phone number is (937) 479-1676.

What is Ohio Medicaid Provider's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Ohio Medicaid Provider was last updated on December 27, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.