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General NPI Number Information
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NPI Number | 1861155590
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Entity Type | Organization
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Legal Business Name | ROOTS HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 2815 STICKNEY AVE
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City | TOLEDO
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State | OH
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Zip | 43608-2579
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Country | US
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Telephone | 419-283-0759
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Fax |
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Provider Business Mailing Address
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Address Line | 512 SANDUSKY ST
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City | TOLEDO
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State | OH
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Zip | 43611-3537
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Country | US
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Telephone | 419-283-0759
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Fax | 419-214-7194
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Authorized Official
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Title or Position | CEO/ DIRECTOR
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Name | LATOYA STALLWORTH
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Credential |
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Telephone | 419-283-0759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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