Provider Demographics
NPI:1184306797
Name:STONE, KYLE (ESQ)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:STONE
Suffix:
Gender:M
Credentials:ESQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2469 APPLEGROVE ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-2077
Mailing Address - Country:US
Mailing Address - Phone:330-268-2980
Mailing Address - Fax:
Practice Address - Street 1:2469 APPLEGROVE ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-2077
Practice Address - Country:US
Practice Address - Phone:330-268-2980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities