Self

NPI #1659789915 in Avonlake, Ohio

Provider Information

NPI Number
1659789915
Entity Type
Organization
Organization Name
Self
Primary Specialty
Home Health
Enumeration Date
Jul 30, 2014
Last Updated
Aug 13, 2014

Practice Location

Address
33803 ELECTRIC BLVD
Address 2
E4
State
Ohio
ZIP Code
44012
Phone
(440) 933-4156

Authorized Official

Name
MS. SANDRA LYNN PESTA, LPN
Title
LPN
Phone
(440) 933-4156

Specialties & Taxonomy Codes

Specialty
Home Health

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