Individual
DEVIAIR BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 N YEARLING RD APT H, WHITEHALL, OH 43213-3816
(225) 846-4008
Mailing address
216 N YEARLING RD APT H, WHITEHALL, OH 43213-3816
(225) 846-4008
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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