Healthcare Provider Details

I. General information

NPI: 1639675143
Provider Name (Legal Business Name): JOANNA HOUSE II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 E SOUTH ST
AKRON OH
44311-2165
US

IV. Provider business mailing address

387 WEST BARTGES ST
AKRON OH
44307-1931
US

V. Phone/Fax

Practice location:
  • Phone: 234-678-9805
  • Fax: 330-849-5051
Mailing address:
  • Phone: 234-678-9805
  • Fax: 330-849-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS LASALLE NOREEN HARRIS
Title or Position: EXECUTIVE DIRECTOR
Credential: CDCAIII, CPRS, S.W.
Phone: 234-678-9805