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General NPI Number Information
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NPI Number | 1235404666
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Entity Type | Organization
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Legal Business Name | OHIO HOMECARE PROGRAM
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 232 FERRIS AVE
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City | TOLEDO
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State | OH
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Zip | 43608-1769
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Country | US
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Telephone | 567-225-8629
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Fax |
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Provider Business Mailing Address
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Address Line | 232 FERRIS AVE
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City | TOLEDO
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State | OH
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Zip | 43608-1769
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Country | US
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Telephone | 567-225-8629
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Fax |
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Authorized Official
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Title or Position | HOME HEALTH AIDE
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Name | KRISTIN LYNN MINKOWSKI
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Credential | NA
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Telephone | 567-225-8629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | RY914035
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License Number State | OH
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