NPI 1104122340

Bureau of Long-Term Care Services and Supports

Organisation Exclusive Provider Organization Akron, OH

Practice location

Address: 818 Kickapoo Ave, Akron, OH 44305-1208
Phone: (330) 780-1270

Authorised official

Name: Sarah Breanna Hanson
Title: Lpn
Phone: (330) 780-1270

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence PN 109895 (OH)

Other Exclusive Provider Organization providers in Ohio →

Registry record

NPI: 1104122340
Entity type: Organization
NPI issued: 7 Feb 2011
Record last updated: 7 Feb 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.