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Organization

HOUSE OF PIECES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE DION ENDRES (OWNER)
(419) 982-2960
Entity
Organization

Contact information

Practice address
109 N MAIN ST STE 209, MANSFIELD, OH 44902-7669
(419) 982-2960
(567) 560-2032
Mailing address
109 N MAIN ST STE 209, MANSFIELD, OH 44902-7669
(419) 982-2960
(567) 560-2032

Taxonomy

Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
3747P1801X
Personal Care Attendant
374U00000X
Home Health Aide
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000263838
SUPPLIER #
05
0365527
OH
01
1701260
CONTRACT PROVIDER # DODD
OH
Enumeration date
12/01/2020
Last updated
12/01/2020
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