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NPI Code Detail

MEDICARE: FOUR SEASONS HEALTH SERVICES, LLC

MEDICARE: FOUR SEASONS HEALTH SERVICES, 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
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225367550
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOUR SEASONS HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : 2165 EASTWOOD AVE
Second Line :
City : AKRON
State : OH
Zip : 44305-2179
Country : US
Telephone Number : 330-733-0100
Fax Number :
Provider Business Practice Location Address
First Line : 2165 EASTWOOD AVE
Second Line :
City : AKRON
State : OH
Zip : 44305-2179
Country : US
Telephone Number : 330-733-0100
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. NICOLE A STANICH
Credential :
Telephone Number : 330-733-0100
Provider Enumeration Date : 12/16/2009
Last Update Date : 05/26/2016

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Directions to “FOUR SEASONS HEALTH SERVICES, LLC ” Practice Location

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