MEDICARE: MUSIC MAKERS 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	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1174337158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUSIC MAKERS LLC

Provider Business Mailing Address
First Line	:	26 EAST AVE
Second Line	:
City	:	ETNA
State	:	OH
Zip	:	43062-9348
Country	:	US
Telephone Number	:	614-963-4080
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 EAST AVE
Second Line	:
City	:	ETNA
State	:	OH
Zip	:	43062-9348
Country	:	US
Telephone Number	:	614-963-4080
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MS. JESSIE OWENS
Credential	:
Telephone Number	:	614-963-4080

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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Directions to “MUSIC MAKERS LLC ” Practice Location

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