Healthcare Provider Details

I. General information

NPI: 1447672928
Provider Name (Legal Business Name): PEAK HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 01/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 MONICA AVE SW
CANTON OH
44706-4525
US

IV. Provider business mailing address

4645 MONICA AVE SW
CANTON OH
44706-4525
US

V. Phone/Fax

Practice location:
  • Phone: 330-224-4100
  • Fax: 888-649-7575
Mailing address:
  • Phone: 330-224-4100
  • Fax: 888-649-7575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGG A ELLIOTT
Title or Position: CEO
Credential:
Phone: 330-224-4100