Healthcare Provider Details

I. General information

NPI: 1518613710
Provider Name (Legal Business Name): DARKHEART APOCATHERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 5TH ST SW
MASSILLON OH
44647-6519
US

IV. Provider business mailing address

519 5TH ST SW
MASSILLON OH
44647-6519
US

V. Phone/Fax

Practice location:
  • Phone: 330-222-3200
  • Fax:
Mailing address:
  • Phone: 330-222-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MEHKYE ASSYRIAN GIVENS
Title or Position: LEAD NATUROPATHIC PHYSICAN
Credential: NMD, SMN, OLO, NESP
Phone: 330-356-7024