Provider Demographics
NPI:1174526149
Name:ALK INC.
Entity type:Organization
Organization Name:ALK INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:740-369-8741
Mailing Address - Street 1:478 S SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2623
Mailing Address - Country:US
Mailing Address - Phone:740-369-8741
Mailing Address - Fax:740-363-8359
Practice Address - Street 1:478 S SANDUSKY ST
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2623
Practice Address - Country:US
Practice Address - Phone:740-369-8741
Practice Address - Fax:740-363-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1413314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0372010Medicaid
OH0372010Medicaid