Healthcare Provider Details

I. General information

NPI: 1811774086
Provider Name (Legal Business Name): PLAYCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 09/12/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6416 WISE AVE NW
NORTH CANTON OH
44720-7351
US

IV. Provider business mailing address

1127 CLEARMOUNT AVE SE
NORTH CANTON OH
44720-3705
US

V. Phone/Fax

Practice location:
  • Phone: 330-353-9532
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY E HARPER
Title or Position: OCCUPATIONAL THERAPIST
Credential: MS OTR/L
Phone: 330-327-1110