Delerisajblank-Inc

Organization Active NPI Home Modifications Contractor · Mount Orab, OH

NPI 1679637987 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1679637987
Entity type
Organization (NPI type 2)
Primary specialty
Home Modifications Contractor 171WH0202X
Legal business name
DELERISAJBLANK-INC
Practice address
16507 Clements Rd
Mount Orab, OH 45154-9765
Phone
(937) 444-3596
Fax
(937) 444-3596
NPI assigned
Dec 21, 2006
Organization subpart
No

Authorized official

Name
Mrs. Delerisa Janet Blank, HOMECARE PROVIDER
Title
Owner
Phone
(937) 444-3596

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor
Group: 193400000X SINGLE SPECIALTY GROUP
171WH0202X OH Yes

Addresses

Primary practice location

16507 Clements Rd
Mount Orab, OH 45154-9765

Mailing address

16507 Clements Rd
Mount Orab, OH 45154-9765
Phone (937) 444-3596

Other identifiers

IdentifierTypeStateIssuer
2429312OtherOHHOMECARE PROVIDER

Other providers in Mount Orab, OH

All providers in Mount Orab, OH · Home Modifications Contractor in Ohio

Sources for this page

Verify at the official NPI Registry.