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General NPI Number Information
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NPI Number | 1659134617
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Entity Type | Organization
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Legal Business Name | WAYMAKER HOMECARE LLC
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 5458 FULTON RD, CANTON OHIO 44718 SUITE B
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City | CANTON
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State | OH
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Zip | 44718
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Country | US
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Telephone | 330-465-4987
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 900
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City | GREEN
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State | OH
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Zip | 44232-1583
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Country | US
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Telephone | 330-417-3027
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LEBERLIZA S STALCUP
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Credential | RN
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Telephone | 330-212-5554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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