# SELF-EMPLOYED

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1689077125
- **Authorized official:** DELMESHA JACKSON HOMEHEALTH (STNA)
- **Authorized official phone:** (440) 251-9701

## Contact information

- **Practice address:** 95B BARLEY DR, PAINESVILLE, OH 44077-5349
- **Practice address phone:** (440) 251-9701
- **Mailing address:** 95B BARLEY DR, PAINESVILLE, OH 44077-5349
- **Mailing address phone:** (440) 251-9701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | 47 | OH | Yes |

## Other

- **Enumeration date:** 09/29/2014
- **Last updated:** 09/29/2014