Healthcare Provider Details

I. General information

NPI: 1174337158
Provider Name (Legal Business Name): MUSIC MAKERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 EAST AVE
ETNA OH
43062-9348
US

IV. Provider business mailing address

26 EAST AVE
ETNA OH
43062-9348
US

V. Phone/Fax

Practice location:
  • Phone: 614-963-4080
  • Fax:
Mailing address:
  • Phone: 614-963-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. JESSIE OWENS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 614-963-4080