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NPI Code Detail

MEDICARE: HARRISON HOMES, INC.

MEDICARE: HARRISON HOMES, INC.
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 Agency4802986OH

General Provider Information

NPI Number : 1538298708
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARRISON HOMES, INC.
Provider Business Mailing Address
First Line : 404 BOSTON PL
Second Line :
City : TOLEDO
State : OH
Zip : 43610-1437
Country : US
Telephone Number : 419-243-4817
Fax Number : 419-243-4817
Provider Business Practice Location Address
First Line : 409 BOSTON PL
Second Line :
City : TOLEDO
State : OH
Zip : 43610-1438
Country : US
Telephone Number : 419-944-0464
Fax Number : 419-243-4817
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : RADONA M. SAMPLE
Credential :
Telephone Number : 419-243-4817
Provider Enumeration Date : 03/05/2007
Last Update Date : 08/22/2020

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