| NPI | 1043823701 |
|---|---|
| Former Legal Business Name | MOTHER HARRELL'S HAVEN |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY VERNON KELLY Owner 330-268-9065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-08-24 |