Healthcare Provider Details

I. General information

NPI: 1669843355
Provider Name (Legal Business Name): CAREGIVER GROVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2015
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 N DETROIT AVE
TOLEDO OH
43607-3930
US

IV. Provider business mailing address

PO BOX 351141
TOLEDO OH
43635-1141
US

V. Phone/Fax

Practice location:
  • Phone: 567-868-8246
  • Fax:
Mailing address:
  • Phone: 567-868-8246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: ARNETHIA LEVEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 567-868-8246