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General NPI Number Information
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NPI Number | 1326448648
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Entity Type | Individual
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Provider Name | DELCENIA KIMBROUGH CARE COORDINATOR
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Gender | Female
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 347 MIDWAY BLVD
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City | ELYRIA
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State | OH
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Zip | 44035-9006
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Country | US
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Telephone | 440-324-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1417 KIMBERLY CT
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City | LORAIN
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State | OH
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Zip | 44053-3512
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Country | US
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Telephone | 410-670-6960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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