Healthcare Provider Details

I. General information

NPI: 1538989801
Provider Name (Legal Business Name): JE'NAY THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 12/19/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 ALVISON RD
TOLEDO OH
43612-2303
US

IV. Provider business mailing address

827 ALVISON RD
TOLEDO OH
43612-2303
US

V. Phone/Fax

Practice location:
  • Phone: 419-973-2437
  • Fax:
Mailing address:
  • Phone: 419-973-2437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: