Individual
CRYSTAL A MCLENDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4805 CASTLEBAR ST NW, CANTON, OH 44708-2045
(330) 430-9662
Mailing address
4805 CASTLEBAR ST NW, CANTON, OH 44708-2045
(330) 430-9662
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
2573442
OH
172A00000X
Driver
—
—
251X00000X
Supports Brokerage Agency
2573442
OH
253Z00000X
In Home Supportive Care Agency
Primary
2573442
OH
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
2573442
OH
347C00000X
Private Vehicle
2573442
OH
372600000X
Adult Companion
2573442
OH
3747P1801X
Personal Care Attendant
2573442
OH
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0385197
—
OH
01
—
2573442
OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES
OH
Enumeration date
12/29/2020
Last updated
11/23/2022
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