Individual
DERRICK JOSE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2013 7TH ST NE, CANTON, OH 44704-1969
(330) 232-0379
Mailing address
2013 7TH ST NE, CANTON, OH 44704-1969
(330) 232-0379
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
RP085271
OH
347C00000X
Private Vehicle
Primary
RP085271
OH
376J00000X
Homemaker
RP085271
OH
385H00000X
Respite Care
RP085271
OH
385HR2055X
Child Mental Illness Respite Care
RP085271
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
RP085271
OH
Other
Enumeration date
04/12/2023
Last updated
09/15/2023
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