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General NPI Number Information
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NPI Number | 1306057195
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Entity Type | Organization
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Legal Business Name | WISH U WELL
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7536 MARKET ST SUITE 204
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City | BOARDMAN
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State | OH
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Zip | 44512
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Country | US
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Telephone | 330-729-9474
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Fax |
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Provider Business Mailing Address
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Address Line | 14219 WESTROPP AVE
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City | CLEVELAND
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State | OH
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Zip | 44110
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Country | US
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Telephone | 216-255-9725
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Fax | 216-255-9749
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TINA C RASBERRY
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Credential | RN
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Telephone | 216-832-5949
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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 |
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License Number State |
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