Organization
BORN TO STAND OUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMARA JARRETT RN, BSN, CEO (CEO)
(330) 353-4991
Entity
Organization
Contact information
Practice address
2715 SANDY LAKE RD, RAVENNA, OH 44266-8210
(330) 353-4991
Mailing address
2715 SANDY LAKE RD, RAVENNA, OH 44266-8210
(330) 353-4991
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0351262
—
OH
Enumeration date
10/02/2019
Last updated
10/02/2019
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