Healthcare Provider Details

I. General information

NPI: 1083221071
Provider Name (Legal Business Name): HUGHES FOSTER FAMILY HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1079 DALE DR
WOOSTER OH
44691-9170
US

IV. Provider business mailing address

1079 DALE DR
WOOSTER OH
44691-9170
US

V. Phone/Fax

Practice location:
  • Phone: 330-749-8755
  • Fax:
Mailing address:
  • Phone: 330-749-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SHARON LYNN HUGHES
Title or Position: CEO
Credential:
Phone: 330-749-8755