Healthcare Provider Details

I. General information

NPI: 1972858322
Provider Name (Legal Business Name): LANNON HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 KELLY AVE
AKRON OH
44306-2816
US

IV. Provider business mailing address

916 KELLY AVE
AKRON OH
44306-2816
US

V. Phone/Fax

Practice location:
  • Phone: 330-319-4511
  • Fax: 775-459-0983
Mailing address:
  • Phone: 330-319-4511
  • Fax: 775-459-0983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2945906
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number2945906
License Number StateOH

VIII. Authorized Official

Name: MS. WILLA LANIER
Title or Position: SUPERVISOR
Credential:
Phone: 330-319-4511