Provider Demographics
NPI:1396454260
Name:GONWAY HOME CARE SERVICES
Entity type:Organization
Organization Name:GONWAY HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PRINCE
Authorized Official - Middle Name:YAN QUOIBIA
Authorized Official - Last Name:GONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-386-8000
Mailing Address - Street 1:4408 AIRPORT HWY APT 23
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-7084
Mailing Address - Country:US
Mailing Address - Phone:419-386-8000
Mailing Address - Fax:
Practice Address - Street 1:4408 AIRPORT HWY APT 23
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7084
Practice Address - Country:US
Practice Address - Phone:419-386-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child