MEDICARE: MAVEN CARE LLC

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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1043751571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAVEN CARE LLC

Provider Business Mailing Address
First Line	:	1511 BRITTAIN CIR
Second Line	:	APT 5
City	:	AKRON
State	:	OH
Zip	:	44310-3662
Country	:	US
Telephone Number	:	251-348-0716
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 BRITTAIN CIR
Second Line	:	APT 5
City	:	AKRON
State	:	OH
Zip	:	44310-3662
Country	:	US
Telephone Number	:	251-348-0716
Fax Number	:

Authorized Official
Title or Position	:	C.E.O
Name	:	MR. TERRYHAYES E. OSUDUEH
Credential	:
Telephone Number	:	251-348-0716

Provider Enumeration Date	:	03/16/2017
Last Update Date	:	03/16/2017

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Directions to “MAVEN CARE LLC ” Practice Location

Language	Start Address	Practice Location

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