Organization
LEADS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN JACKSON KEIRNS (PRESIDENT & CEO)
(740) 345-0809
Entity
Organization
Contact information
Practice address
159 WILSON ST, NEWARK, OH 43055-4921
(740) 258-6112
Mailing address
159 WILSON ST, NEWARK, OH 43055-4921
(740) 258-6112
(740) 349-8087
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2090704
MEDICARE
OH
Enumeration date
12/02/2020
Last updated
03/25/2026
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