Healthcare Provider Details

I. General information

NPI: 1992529796
Provider Name (Legal Business Name): FAMILY MATTERS TOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 11/09/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3226 DOLORES AVE
TOLEDO OH
43607-2724
US

IV. Provider business mailing address

3226 DOLORES AVE
TOLEDO OH
43607-2724
US

V. Phone/Fax

Practice location:
  • Phone: 419-779-4694
  • Fax:
Mailing address:
  • Phone: 419-779-4694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. NACHAEL MARIE CHURCH
Title or Position: BOARD OF DIRECTOR
Credential:
Phone: 419-779-4694