Healthcare Provider Details

I. General information

NPI: 1790532349
Provider Name (Legal Business Name): A MEANINGFUL CONNECTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 OAK ALLEY CT STE 304
TOLEDO OH
43606-1365
US

IV. Provider business mailing address

3454 OAK ALLEY CT STE 304
TOLEDO OH
43606-1365
US

V. Phone/Fax

Practice location:
  • Phone: 419-870-9461
  • Fax: 567-429-0185
Mailing address:
  • Phone: 419-870-9461
  • Fax: 567-429-0185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: LEONNA TIERRA JACKSON
Title or Position: OWNER AND DIRECTOR OF OPERATIONS
Credential: LISW-S
Phone: 419-870-9461