Healthcare Provider Details

I. General information

NPI: 1275815128
Provider Name (Legal Business Name): JUST LIKE HOME ACF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 NORTH RD NE
WARREN OH
44483-3657
US

IV. Provider business mailing address

1610 NORTH RD NE
WARREN OH
44483-3657
US

V. Phone/Fax

Practice location:
  • Phone: 330-372-2507
  • Fax:
Mailing address:
  • Phone: 330-372-2507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. EUGENIA MIHAS
Title or Position: OWNER
Credential:
Phone: 330-372-2507