Organization
GRANDMALOVE LLC
Active
Organization
GRANDMALOVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAWNDA ANN WILSON-PRYOR STNA (OWNER)
(513) 978-8760
Entity
Organization
Contact information
Practice address
2986 HIGH FOREST LN APT 119, CINCINNATI, OH 45223-1335
(513) 978-8760
Mailing address
2986 HIGH FOREST LN, 119, CINCINNATI, OH 45223-1335
(513) 978-8760
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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