Healthcare Provider Details

I. General information

NPI: 1972425759
Provider Name (Legal Business Name): MARGARET MARY DVORAK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17617 RIDGE CREEK RD
STRONGSVILLE OH
44136-4359
US

IV. Provider business mailing address

17617 RIDGE CREEK RD
STRONGSVILLE OH
44136-4359
US

V. Phone/Fax

Practice location:
  • Phone: 440-479-8361
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1831714
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: