Healthcare Provider Details

I. General information

NPI: 1750246120
Provider Name (Legal Business Name): JUANITA MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HOWLAND WILSON RD NE
WARREN OH
44484-2116
US

IV. Provider business mailing address

2359 KNOLLWOOD AVE
YOUNGSTOWN OH
44514-1525
US

V. Phone/Fax

Practice location:
  • Phone: 216-260-1405
  • Fax: 330-632-8823
Mailing address:
  • Phone: 216-260-1405
  • Fax: 330-632-8823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberTU245477
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: