Healthcare Provider Details

I. General information

NPI: 1477245918
Provider Name (Legal Business Name): TAKING ROOT FARMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 08/06/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 S TRIMBLE RD
MANSFIELD OH
44906-3449
US

IV. Provider business mailing address

PO BOX 3502
MANSFIELD OH
44907-0502
US

V. Phone/Fax

Practice location:
  • Phone: 419-688-0019
  • Fax:
Mailing address:
  • Phone: 419-688-0019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ANGELA M EISAMAN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 419-688-0019