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Organization

PHENOMENAL CARE SERVICES LLC

Active
Other names
Phenomenal Care Services
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DARRYL WAYNE PETERSON II (CEO)
(234) 521-1318
Entity
Organization

Contact information

Practice address
3040 WICKER ST NE, CANTON, OH 44721-2298
(234) 521-1318
Mailing address
PO BOX 44, MIDDLEBRANCH, OH 44652-0044
(234) 521-1318

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
347C00000X
Private Vehicle
Primary

Other

Enumeration date
07/06/2023
Last updated
07/06/2023
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