Healthcare Provider Details

I. General information

NPI: 1376034132
Provider Name (Legal Business Name): UNIFIED HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2018
Last Update Date: 05/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 EASTLAND AVE
AKRON OH
44305-2654
US

IV. Provider business mailing address

294 EASTLAND AVE
AKRON OH
44305-2654
US

V. Phone/Fax

Practice location:
  • Phone: 330-608-9788
  • Fax:
Mailing address:
  • Phone: 330-608-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANTOINETTE LASALLE MILLS
Title or Position: OWNER
Credential: RN
Phone: 330-608-9788