=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477799450
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OUR FRIENDS AND FAMILY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/23/2008
-----------------------------------------------------
Last Update Date | 12/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 273 WOOSTER RD N UNIT A1
-----------------------------------------------------
City | BARBERTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44203-2330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-858-2734
-----------------------------------------------------
Fax | 330-745-9295
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 264 273 WOOSTER RD. N STE. A1
-----------------------------------------------------
City | BARBERTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44203-0264
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-858-2734
-----------------------------------------------------
Fax | 330-745-9295
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. LORI RENEE WENGER
-----------------------------------------------------
Credential | CSA
-----------------------------------------------------
Telephone | 330-858-2734
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | 1684369
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------