Organization
KIMBERLY WHITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY REGINA WHITE RN (RN)
(440) 579-5294
Entity
Organization
Contact information
Practice address
137 PEARL ST, PAINESVILLE, OH 44077-3579
(440) 579-5294
Mailing address
137 PEARL ST, PAINESVILLE, OH 44077-3579
(440) 579-5294
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
163W00000X
OH
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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