Healthcare Provider Details

I. General information

NPI: 1790548519
Provider Name (Legal Business Name): DASHANA SIMMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 KARSON DR
AKRON OH
44312-3664
US

IV. Provider business mailing address

224 KARSON DR
AKRON OH
44312-3664
US

V. Phone/Fax

Practice location:
  • Phone: 330-618-4129
  • Fax:
Mailing address:
  • Phone: 330-618-4129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberTF604755
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberTF604755
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberTF604755
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberTF604755
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberTF604755
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: