Healthcare Provider Details

I. General information

NPI: 1003513870
Provider Name (Legal Business Name): SHANTI HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E TALLMADGE AVE
AKRON OH
44310-2338
US

IV. Provider business mailing address

1897 BRITTAIN RD
AKRON OH
44310-1843
US

V. Phone/Fax

Practice location:
  • Phone: 360-915-3977
  • Fax:
Mailing address:
  • Phone: 360-915-3977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BHAKTA RIZAL
Title or Position: MANAGER
Credential:
Phone: 360-915-3977