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General NPI Number Information
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NPI Number | 1053523183
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Entity Type | Organization
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Legal Business Name | GIFTS OF LIFE, LLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 860 LEXINGTON AVENUE
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City | MANSFIELD
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State | OH
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Zip | 44907
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Country | US
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Telephone | 419-775-8886
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Fax |
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Provider Business Mailing Address
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Address Line | 860 LEXINGTON AVENUE
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City | MANSFIELD
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State | OH
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Zip | 44907
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Country | US
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Telephone | 419-775-8886
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | SHERRIE BLAIR THOMAS
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Credential | MSW,LISW
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Telephone | 419-775-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I10060
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License Number State | OH
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