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General NPI Number Information
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NPI Number | 1720849383
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Entity Type | Organization
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Legal Business Name | QUTIE AND THE BEARDS
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 1496 LAKEVIEW ST
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City | LAKEMORE
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State | OH
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Zip | 44250-9593
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Country | US
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Telephone | 440-444-7363
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Fax |
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Provider Business Mailing Address
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Address Line | 1496 LAKEVIEW ST # 294
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City | LAKEMORE
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State | OH
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Zip | 44250-9593
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Country | US
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Telephone | 440-444-7363
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | QUISHELLE L SHELTON
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Credential |
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Telephone | 440-444-7363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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