=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285446807
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONYX TREASURES CARE SERVICE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2025
-----------------------------------------------------
Last Update Date | 01/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3311 EVANSTON CT
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43610-1137
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-309-8573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3311 EVANSTON CT
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43610-1137
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-309-8573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | MRS. SHELLY M JONES
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 419-309-8573
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------