HALL OF FAME RESIDENTIAL SERVICES (NPI# 1932638038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932638038 |
| Entity Type | Organization |
| Organization Name | HALL OF FAME RESIDENTIAL SERVICES |
| Practice Address |
6691 Freedom Ave Nw Canton OH 44720-7301 |
| Practice Telephone | (234) 714-9320 |
| Mailing Telephone | 2347149320 |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2017-06-12 |
| Authorized Official Name | MELISSA ANN WEBSTER (COO) |
| Authorized Official Telephone | 2347149320 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251J00000X | Nursing Care | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 3067345 | 05 |
| Street Address |
6691 FREEDOM AVE NW |
| City | CANTON |
| State | OH |
| Zip Code | 44720-7301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700351251 | Mark Allan Joki | Counselor | 1303 W. Maple St., Suite 103, North Canton, OH 44720 | 2018-10-11 |
| 1700305794 | Alexis Katherine Hundley | Specialist/Technologist | 1378 Devon Drive, North Canton, OH 44720 | 2017-09-12 |
| 1376060780 | Universal Impex Inc. | Day Training, Developmentally Disabled Services | 6868 Farmcrest Cir Nw., North Canton, OH 44720 | 2017-08-25 |
| 1083066203 | Wendy Barnett | Registered Nurse | 8722 Grimes Ave Nw, North Canton, OH 44720 | 2016-07-12 |
| 1336590389 | Amanda L Cockerell | Occupational Therapy Assistant | 330 E Maple St, North Canton, OH 44720 | 2016-06-30 |
| 1467808063 | Ryan Monti | Physical Therapist | 6285 Promler St Nw, North Canton, OH 44720 | 2016-05-12 |
| 1467816124 | Jami Lynn Fisher | Occupational Therapist | 6057 Strip Avenue Nw, North Canton, OH 44720 | 2016-04-08 |
| 1801255427 | Steven R Fricke | Psychologist | 239 Portage St. Ne, North Canton, OH 44720 | 2016-02-11 |
| 1396124814 | Burkins Ritchie & Assco LLC | Counselor | 1206 N. Main St, North Canton, OH 44720 | 2015-05-29 |
| 1073992590 | Max Dean Burkins | Counselor | 1206 N. Main St., North Canton, OH 44720 | 2015-05-29 |
| Find all providers in zip 44720 | ||||
| Taxonomy Code | 251J00000X |
| Grouping | Agencies |
| Classification | Nursing Care |
| A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598381907 | Nieshia West | Nursing Care | 201 Wertz Ave Sw, Canton, OH 44710-2404 | 2020-06-22 |
| 1770108896 | Building New Pathways Home Health Care LLC | Nursing Care | 4461 S Sheldon Rd, Canton, MI 48188-2522 | 2020-06-15 |
| 1467960039 | Lum Personal Care Home, LLC | Nursing Care | 1132 Copper Creek Dr, Canton, GA 30114-8178 | 2018-01-17 |
| 1962949883 | Chauntelle Andrews | Nursing Care | 3210 14th St Sw, Canton, OH 44710 | 2017-01-30 |
| 1013241322 | Assisted Living Corporation of Ga | Nursing Care | 149 Shady Ln, Canton, GA 30114-7960 | 2009-09-21 |
| 1356512867 | Caring R Us, LLC | Nursing Care | 905 Turnpike St Ste E1, Canton, MA 02021-2833 | 2008-03-12 |
| 1497849848 | Netsource Health Services Ltd | Nursing Care | 2812 7th St Nw, Canton, OH 44708-4315 | 2006-10-02 |
| 1932727005 | Compassionate Care Home Health Service | Nursing Care | 242 W North St, Canton, MS 39046-3723 | 2020-07-06 |
| 1962041798 | Kids' Kastle Gluckstadt | Nursing Care | 112 Westfalen Drive, Canton, MS 39046 | 2019-12-26 |
| 1922641802 | Gables Canton | Nursing Care | 3660 Greentree Ave Sw, Canton, OH 44706-4024 | 2019-10-23 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.