Healthcare Provider Details

I. General information

NPI: 1922926278
Provider Name (Legal Business Name): MICHAEL L WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 BERYL DR
KENT OH
44240-4402
US

IV. Provider business mailing address

418 BERYL DR
KENT OH
44240-4402
US

V. Phone/Fax

Practice location:
  • Phone: 330-554-3735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: