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General NPI Number Information
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NPI Number | 1164366944
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Entity Type | Organization
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Legal Business Name | MIKAYLAS MISSION
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 2215 E WATERLOO RD STE 104
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City | AKRON
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State | OH
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Zip | 44312-3818
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Country | US
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Telephone | 330-933-4795
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Fax |
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Provider Business Mailing Address
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Address Line | 7801 PROUTY RD
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City | LODI
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State | OH
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Zip | 44254-9614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MRS. LISA KAY COUGHENOUR
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Credential |
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Telephone | 330-933-4795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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