Peter Paul Williams

Individual provider Active NPI In Home Supportive Care Agency · Mantua, OH

NPI 1114533494 · NPPES record last updated Nov 13, 2020

Key facts

NPI
1114533494
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Practice address
3301 Frost Rd
Mantua, OH 44255-9487
Phone
(216) 339-9401
NPI assigned
Sep 22, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X OH Yes

Addresses

Primary practice location

3301 Frost Rd
Mantua, OH 44255-9487

Mailing address

3301 Frost Rd
Mantua, OH 44255-9487
Phone (216) 339-9401

Other identifiers

IdentifierTypeStateIssuer
0000274471OtherOHOAKS.STATE.OH.US OHIO SHARED SERVICES

Other providers in Mantua, OH

All providers in Mantua, OH · In Home Supportive Care Agency in Ohio

Sources for this page

Verify at the official NPI Registry.