Healthcare Provider Details

I. General information

NPI: 1285065375
Provider Name (Legal Business Name): RAKEIA ROUNDTREE INDEPENDENT PROVIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2013
Last Update Date: 09/29/2026
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 W BANCROFT ST
TOLEDO OH
43606-4613
US

IV. Provider business mailing address

PO BOX 3333
TOLEDO OH
43607-0333
US

V. Phone/Fax

Practice location:
  • Phone: 419-326-5535
  • Fax:
Mailing address:
  • Phone: 419-326-5535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number401238240511
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: