Basic Information
| Provider Information | |||||||||
| NPI: | 1912412768 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ENCOMPASS CARE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 SHAWNEE AVENUE | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45805 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 SHAWNEE RD | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458053529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193025465 | ||||||||
| FaxNumber: | 4199996284 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2017 | ||||||||
| LastUpdateDate: | 03/22/2019 | ||||||||
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| AuthorizedOfficialLastName: | UNVERFERTH | ||||||||
| AuthorizedOfficialFirstName: | CHAD | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT - FINANCE & CFO | ||||||||
| AuthorizedOfficialTelephone: | 4199992010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 0324227 | 05 | OH | MEDICAID |