Healthcare Provider Details

I. General information

NPI: 1215980560
Provider Name (Legal Business Name): DHSC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 8TH ST NE
MASSILLON OH
44646-8503
US

IV. Provider business mailing address

14114 COLLECTION CENTER DR
CHICAGO IL
60693-0141
US

V. Phone/Fax

Practice location:
  • Phone: 330-837-7200
  • Fax: 330-830-1616
Mailing address:
  • Phone: 330-837-7200
  • Fax: 330-830-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number1016
License Number StateOH

VIII. Authorized Official

Name: TARA P RICHARDSON
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 615-221-3672