Healthcare Provider Details

I. General information

NPI: 1972467843
Provider Name (Legal Business Name): KNM HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4681 SOUTHAIRE DR
TOLEDO OH
43615-6123
US

IV. Provider business mailing address

4681 SOUTHAIRE DR
TOLEDO OH
43615-6123
US

V. Phone/Fax

Practice location:
  • Phone: 419-276-7944
  • Fax: 419-276-7944
Mailing address:
  • Phone: 419-276-7944
  • Fax: 419-276-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: QUINTELLA MITCHELL
Title or Position: CO-OWNER
Credential:
Phone: 419-276-7944