MEDICARE: LAURA A HAAS HPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1003410515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA A HAAS HPC

Provider Business Mailing Address
First Line	:	1608 WOODLAWN AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-2775
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1608 WOODLAWN AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-2775
Country	:	US
Telephone Number	:	330-705-0637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2020
Last Update Date	:	11/24/2020

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Directions to “ LAURA A HAAS HPC” Practice Location

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