Provider Demographics
NPI:1851768956
Name:LA JENA SOLOMON
Entity Type:Organization
Organization Name:LA JENA SOLOMON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERSONAL CARE AIDE
Authorized Official - Prefix:
Authorized Official - First Name:LA JENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-397-3630
Mailing Address - Street 1:633 PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1733
Mailing Address - Country:US
Mailing Address - Phone:330-397-3630
Mailing Address - Fax:
Practice Address - Street 1:633 PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1733
Practice Address - Country:US
Practice Address - Phone:330-397-3630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0135444251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health