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General NPI Number Information
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NPI Number | 1699919928
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Entity Type | Organization
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Legal Business Name | BACK ON CALL, LLC
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 197 GREAT OAKS TRL # 140
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City | WADSWORTH
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State | OH
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Zip | 44281-8215
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Country | US
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Telephone | 330-335-4804
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Fax | 330-335-4806
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Provider Business Mailing Address
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Address Line | 197 GREAT OAKS TRL # 140
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City | WADSWORTH
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State | OH
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Zip | 44281-8215
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Country | US
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Telephone | 330-335-4804
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Fax | 330-335-4806
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHERYL LYNN BACK
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Credential | M.N.S., CCC-SLP
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Telephone | 330-335-4804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | SP-4804
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License Number State | OH
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