Healthcare Provider Details

I. General information

NPI: 1750808473
Provider Name (Legal Business Name): JANAE WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2278 CORDOVA AVE
YOUNGSTOWN OH
44504
US

IV. Provider business mailing address

2278 CORDOVA AVE
YOUNGSTOWN OH
44504-1813
US

V. Phone/Fax

Practice location:
  • Phone: 330-951-2827
  • Fax:
Mailing address:
  • Phone: 330-951-2827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: