=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760248959
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HTL MANAGEMENT INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2024
-----------------------------------------------------
Last Update Date | 03/13/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 104 3RD ST NW
-----------------------------------------------------
City | BARBERTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44203-8223
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 234-285-7818
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 104 3RD ST NW
-----------------------------------------------------
City | BARBERTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44203-8223
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 234-285-7818
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | SHARON JONES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 234-285-7818
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 332U00000X
-----------------------------------------------------
Taxonomy Name | Home Delivered Meals
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------