Organization
INDIVIDUAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TAMMIE LYNN MAYLE (HOME HEALTH AID)
(330) 265-7902
Entity
Organization
Contact information
Practice address
1111 GONDER AV SE, CANTON, OH 44707
(330) 265-7902
Mailing address
1111 GONDER AV SE, CANTON, OH 44707
(330) 265-7902
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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