# EDIYE ENOOBONG

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669882601
- **Authorized official:** EDIYE JOY ENOOBONG NURSE (LICENSED PRACTICAL NURSE)
- **Authorized official phone:** (614) 377-9044

## Contact information

- **Practice address:** 4672 HARBINGER CIR W, WHITEHALL, OH 43213-6115
- **Practice address phone:** (614) 377-9044
- **Practice address fax:** (614) 453-5712
- **Mailing address:** 4672 HARBINGER CIR W, WHITEHALL, OH 43213-6115
- **Mailing address phone:** (614) 377-9044
- **Mailing address fax:** (614) 453-5712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 156004 | OH | Yes |

## Other

- **Enumeration date:** 04/29/2014
- **Last updated:** 04/29/2014