Healthcare Provider Details

I. General information

NPI: 1528872595
Provider Name (Legal Business Name): PUZZLE LAND INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2025
Last Update Date: 02/01/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 ASHWOOD AVE
DAYTON OH
45405-2643
US

IV. Provider business mailing address

201 LORETTA DR
DAYTON OH
45415-3508
US

V. Phone/Fax

Practice location:
  • Phone: 937-673-8951
  • Fax: 937-742-7260
Mailing address:
  • Phone: 937-673-8951
  • Fax: 937-742-7260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE G PIPPINS
Title or Position: BOARD PRESIDENT
Credential:
Phone: 937-673-8951