Healthcare Provider Details

I. General information

NPI: 1053261107
Provider Name (Legal Business Name): MONTEROSA CHRONIC CARE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 SOUTHWIND CT
COLUMBUS OH
43230-3127
US

IV. Provider business mailing address

6545 MARKET AVE N STE 100
CANTON OH
44721-2430
US

V. Phone/Fax

Practice location:
  • Phone: 614-414-2154
  • Fax:
Mailing address:
  • Phone: 614-414-2154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: YAZMEEN JOHNSON
Title or Position: OWNER
Credential: LPN
Phone: 614-414-2154