JEANETTA (NPI# 1770606535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770606535 |
| Entity Type | Organization |
| Organization Name | JEANETTA |
| Practice Address |
2784 Viola St Sw Warren OH 44485-3343 |
| Mailing Address |
2784 Viola S.t S.w Warren OH 44485 |
| Practice Telephone | 3308986413 |
| Practice Fax Number | 3308986417 |
| Mailing Telephone | 3308986413 |
| Mailing Fax Number | 3308986414 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. JEANETTA ANN CHATMON I (CARE PROVIDER) |
| Authorized Official Telephone | 3308986413 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | JEANETTA D SIMS | 15017 Longford Way, Edmond, OK 73013 |
| Connecticut Business Registrations | Jeanetta Enterprise LLC | 37 Erika Cir, Bridgeport, CT 06606 |
| New York State Corporations | JEANETTA PATTERSON LLC | 6 Clement Avenue, Saratoga Springs, New York 12866 |
| Street Address |
2784 VIOLA ST SW |
| City | WARREN |
| State | OH |
| Zip Code | 44485-3343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780284752 | Heather Lynn Ayres | Technician | 4046 North Leavitt Rd Nw, Warren, OH 44485 | 2020-10-29 |
| 1730576315 | Jeanetta Chatmon | Community Health Worker | 1447 Kensington St. Nw, Warren, OH 44485 | 2015-04-21 |
| 1003201351 | Laneka Oliver | Home Health | 1655 Denison Ave, Warren, OH 44485 | 2015-04-03 |
| 1437401155 | Rhoda Darlene Killingworth | Nurse's Aide | 1510 Arthur Dr Nw, Warren, OH 44485 | 2012-10-04 |
| 1477844033 | Lakshmi Padmanabhan | Pharmacist | 1560 Parkman Road, Rite Aid Pharmacy, Warren, OH 44485 | 2011-04-29 |
| 1225332422 | Dashah Brendae Adams | Licensed Practical Nurse | 3270 Dunstan Dr. Nw, Warren, OH 44485 | 2011-01-03 |
| 1982854188 | Deanna Lynne Nussle | Registered Nurse | 1480 Tod Ave, Warren, OH 44485 | 2008-09-24 |
| 1003093170 | Kila E Mcghee | Home Health | 1108 Tod Ave Nw, Warren, OH 44485 | 2008-01-30 |
| 1639372816 | Stella L Reese | Home Health Aide | 1890 Northfield Nw, Attn Karen Morgan, Warren, OH 44485 | 2007-06-06 |
| 1417016239 | Laura Marie Buck | Counselor | Louis Stokes Cleveland Medical Center, 1406 Tod Ave Nw Warren Va Cboc, Warren, OH 44485 | 2006-12-07 |
| Find all providers in zip 44485 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740801844 | Metro Care Group LLC. | Custodial Care Facility | 20965 Nummer St, Warren, MI 48089-5135 | 2020-04-29 |
| 1083041594 | Ab Kha #1 Place Adult Care Home | Custodial Care Facility | 20815 Montrose Ave, Warren, MI 48089-3464 | 2013-09-28 |
| 1487920021 | Abiding Love I LLC | Custodial Care Facility | 31641 Wixson Dr, Warren, MI 48092-5015 | 2012-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315103 | Friend Home | Custodial Care Facility | 121 Wolf Rd, Mansfield, OH 44903-8739 | 2020-10-28 |
| 1902404098 | Carol Noss | Custodial Care Facility | 6481 Dale Dr, Brookpark, OH 44142-3454 | 2020-10-12 |
| 1679189138 | Four Seasons Ranch, LLC. | Custodial Care Facility | 5625 Elm Hill Dr, Solon, OH 44139-1943 | 2020-09-21 |
| 1336754696 | David L Thompson | Custodial Care Facility | 59 West St, Jackson, OH 45640-1566 | 2020-09-14 |
| 1598393092 | Ebony Monique Eaddie | Custodial Care Facility | 3523 Woodridge Rd, Cleveland Heights, OH 44121-1533 | 2020-03-30 |
| 1710536354 | Dare To Be Different, LLC | Custodial Care Facility | 6303 Luther Ave, Cleveland, OH 44103-2575 | 2019-09-06 |
| 1396309258 | Patricia Sims | Custodial Care Facility | 6648 Afton Ave, Cincinnati, OH 45213-1130 | 2019-04-26 |
| 1285190264 | Felicia Hawkins | Custodial Care Facility | 2942 Banning Rd Apt 220, Cincinnati, OH 45239-5584 | 2019-02-14 |
| 1225507304 | Shirleen Barbara Ross | Custodial Care Facility | 3315 Mayo St Apt 111, Toledo, OH 43611-3260 | 2018-11-18 |
| 1770050023 | Cierra Thompson | Custodial Care Facility | 5599 Westerville Rd, Westerville, OH 43081-9365 | 2018-10-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JEANETTA.
| 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.