Healthcare Provider Details

I. General information

NPI: 1831811587
Provider Name (Legal Business Name): CARE PERSONIFIED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6725 PROMWAY AVE NW STE 14
NORTH CANTON OH
44720-7317
US

IV. Provider business mailing address

6725 PROMWAY AVE NW STE 14
NORTH CANTON OH
44720-7317
US

V. Phone/Fax

Practice location:
  • Phone: 234-738-0924
  • 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 State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KANDACE HARRIS
Title or Position: OWNER
Credential: STNA
Phone: 234-738-0924