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Organization

HEART ON ICE

Active
Other names
Heart On Ice
Organization subpart
No

Provider details

NPI number
Authorized official
MR. FEISAL CRUMBY JR. (DOO)
(419) 360-7994
Entity
Organization

Contact information

Practice address
4736 N TEAL LN, OREGON, OH 43616-1674
(419) 360-7994
Mailing address
4736 N TEAL LN, OREGON, OH 43616-1674
(419) 360-7994

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
253Z00000X
In Home Supportive Care Agency
261QA0600X
Adult Day Care Clinic/Center
Primary
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle

Other

Enumeration date
04/23/2024
Last updated
04/23/2024
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