Organization
DELERISAJBLANK-INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELERISA JANET BLANK HOMECARE PROVIDER (OWNER)
(937) 444-3596
Entity
Organization
Contact information
Practice address
16507 CLEMENTS RD, MOUNT ORAB, OH 45154-9765
(937) 444-3596
(937) 444-3596
Mailing address
16507 CLEMENTS RD, MOUNT ORAB, OH 45154-9765
(937) 444-3596
(937) 444-3596
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2429312
HOMECARE PROVIDER
OH
Enumeration date
12/21/2006
Last updated
08/22/2020
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