Provider Demographics
NPI:1346545332
Name:WILBDONE
Entity Type:Organization
Organization Name:WILBDONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:BERNADETTE
Authorized Official - Last Name:PERRIN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:330-639-4165
Mailing Address - Street 1:2664 CLEVELAND AVE SW REAR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44707-3647
Mailing Address - Country:US
Mailing Address - Phone:330-639-4165
Mailing Address - Fax:330-639-4167
Practice Address - Street 1:2664 CLEVELAND AVE SW REAR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44707-3647
Practice Address - Country:US
Practice Address - Phone:330-639-4165
Practice Address - Fax:330-639-4167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care