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General NPI Number Information
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NPI Number | 1316294184
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Entity Type | Organization
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Legal Business Name | 2ND II NONE OF OHIO INC.
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Dates
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Enumeration Date | 08/10/2012
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | 2011 S HEIGHTS AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44502-2949
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Country | US
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Telephone | 330-501-1698
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Fax |
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Provider Business Mailing Address
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Address Line | 2011 S HEIGHTS AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44502-2949
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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 | OWNER
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Name | KANDANCE AKINS
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Credential |
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Telephone | 330-501-1698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 2099AFH
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License Number State | OH
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