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Organization
WAIVER PROVIDER
Active
Organization
WAIVER PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINA HOPE STANDRIDGE (LPN)
(419) 606-5213
Entity
Organization
Contact information
Practice address
1645 HARDING AVE, ASHLAND, OH 44805-3555
(419) 606-5213
Mailing address
1645 HARDING AVE, ASHLAND, OH 44805-3555
(419) 606-5213
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PN.124691-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN.124691-IV
LPN LICENSE
OH
Enumeration date
12/24/2007
Last updated
12/24/2007
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