Provider Demographics
NPI:1821843848
Name:HARMONY HOUSE YOUTH SERVICES LLC
Entity type:Organization
Organization Name:HARMONY HOUSE YOUTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:440-661-7920
Mailing Address - Street 1:5458 FULTON DR NW STE I
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-4311
Mailing Address - Country:US
Mailing Address - Phone:440-661-7920
Mailing Address - Fax:
Practice Address - Street 1:5458 FULTON DR NW STE I
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-4311
Practice Address - Country:US
Practice Address - Phone:440-661-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health