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General NPI Number Information
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NPI Number | 1639675143
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Entity Type | Organization
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Legal Business Name | JOANNA HOUSE II
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 342 E SOUTH ST
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City | AKRON
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State | OH
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Zip | 44311-2165
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Country | US
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Telephone | 234-678-9805
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Fax | 330-849-5051
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Provider Business Mailing Address
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Address Line | 387 WEST BARTGES ST
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City | AKRON
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State | OH
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Zip | 44307-1931
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Country | US
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Telephone | 234-678-9805
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Fax | 330-849-5051
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISS LASALLE NOREEN HARRIS
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Credential | CDCAIII, CPRS, S.W.
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Telephone | 234-678-9805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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