=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366041816
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REIGN RESIDENTIAL AND DAY SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2020
-----------------------------------------------------
Last Update Date | 10/25/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1058 CLARK ST STE D
-----------------------------------------------------
City | HOLLAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43528-7950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-441-0300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1058 CLARK ST STE D
-----------------------------------------------------
City | HOLLAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43528-7950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-441-0300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MR. MARK FRAMES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 419-441-0030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 347C00000X
-----------------------------------------------------
Taxonomy Name | Private Vehicle
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 376J00000X
-----------------------------------------------------
Taxonomy Name | Homemaker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------