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General NPI Number Information
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NPI Number | 1508584228
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Entity Type | Organization
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Legal Business Name | SALLYS GENTLE HANDS
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 1028 W SYLVANIA AVE
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City | TOLEDO
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State | OH
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Zip | 43612-1702
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Country | US
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Telephone | 567-288-3015
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Fax | 419-535-6657
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Provider Business Mailing Address
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Address Line | 1028 W SYLVANIA AVE
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City | TOLEDO
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State | OH
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Zip | 43612-1702
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Country | US
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Telephone | 567-288-3015
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Fax | 419-535-6657
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE SHAKERA GIST
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Credential | STNA
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Telephone | 567-288-3015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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