Healthcare Provider Details
I. General information
NPI: 1285563122
Provider Name (Legal Business Name): PATRICE PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2120 WOODFORD ST
TOLEDO OH
43605-1373
US
IV. Provider business mailing address
2120 WOODFORD ST
TOLEDO OH
43605-1373
US
V. Phone/Fax
- Phone: 313-412-5536
- Fax:
- Phone: 313-412-5536
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171W00000X |
| Taxonomy | Contractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: