Healthcare Provider Details

I. General information

NPI: 1104747930
Provider Name (Legal Business Name): DOROTHY LOUISE CONGROVE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 ROZELLE CREEK RD
CHILLICOTHEE OH
45601-8942
US

IV. Provider business mailing address

1546 ROZELLE CREEK RD
CHILLICOTHEE OH
45601-8942
US

V. Phone/Fax

Practice location:
  • Phone: 740-701-8901
  • Fax: 740-663-5897
Mailing address:
  • Phone: 740-701-8901
  • Fax: 740-663-5897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: