Provider Demographics
NPI:1174223721
Name:AJA PRINCIPLED LIVING GOOD COMPANY
Entity type:Organization
Organization Name:AJA PRINCIPLED LIVING GOOD COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:740-669-6466
Mailing Address - Street 1:7050 WOODDUCK CT
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-5080
Mailing Address - Country:US
Mailing Address - Phone:740-669-6466
Mailing Address - Fax:
Practice Address - Street 1:7050 WOODDUCK CT
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-5080
Practice Address - Country:US
Practice Address - Phone:740-669-6466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No305S00000XManaged Care OrganizationsPoint of Service
No177F00000XOther Service ProvidersLodging
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH305S00000XMedicaid
OH177F00000XMedicaid
OH374K00000XMedicaid
OH171M00000XMedicaid
OH174H00000XMedicaid
OH251B00000XMedicaid
OH171400000XMedicaid