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General NPI Number Information
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NPI Number | 1295450740
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Entity Type | Organization
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Legal Business Name | SPM COMMUNITY SERVICES LLC
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Dates
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Enumeration Date | 10/06/2022
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 2364 ZIRCON ST NE
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City | CANTON
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State | OH
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Zip | 44721-1741
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Country | US
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Telephone | 330-353-8373
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Fax |
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Provider Business Mailing Address
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Address Line | 2364 ZIRCON ST NE
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City | CANTON
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State | OH
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Zip | 44721-1741
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Country | US
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Telephone | 330-353-8373
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | DWAYNE EDWARD SEYMOUR
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Credential |
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Telephone | 330-685-2201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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