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General NPI Number Information
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NPI Number | 1669691937
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Entity Type | Organization
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Legal Business Name | ODJFS
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 1369 E 27TH ST
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City | ASHTABULA
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State | OH
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Zip | 44004-5103
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Country | US
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Telephone | 440-992-8470
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Fax |
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Provider Business Mailing Address
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Address Line | 1369 E 27TH ST
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City | ASHTABULA
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State | OH
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Zip | 44004-5103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HOME HEALTH AIDE
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Name | MRS. ROBIN HENSON
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Credential |
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Telephone | 440-992-8470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 2436162
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License Number State | OH
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