1306567896 NPI number — GUIDING HOUSE, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306567896 NPI number — GUIDING HOUSE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GUIDING HOUSE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306567896
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2789 LEGACY ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIONTOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44685-5705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-807-2749
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4429 FULTON DR NW UNIT 8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44718-2867
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-778-2919
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/05/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PARIS
Authorized Official First Name:
JANELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
FOUNDEER
Authorized Official Telephone Number:
330-778-2919

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)