Healthcare Provider Details

I. General information

NPI: 1992420616
Provider Name (Legal Business Name): TERESA ARMSTRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W GRAMERCY AVE
TOLEDO OH
43612-2528
US

IV. Provider business mailing address

222 W GRAMERCY AVE
TOLEDO OH
43612-2528
US

V. Phone/Fax

Practice location:
  • Phone: 614-625-6754
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number2572176
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: