| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JEFFREY ANTOINE SMALL | 1942058144 | 2024-05-11 |
Jeffrey Antoine Small is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1942058144. Registration indicates Jeffrey Antoine Small is a provider of services with a specialization in Nursing & Custodial Care Facilities, Assisted Living Facility (Assisted Living Facility: Assisted Living, Mental Illness, ) (Assisted Living Facility Assisted Living, Mental Illness, Nursing & Custodial Care Facilities) (Assisted Living Facility, )
| Entity Type | Individual |
| Provider Name | Jeffrey Antoine Small |
| Practice Office Address | 4042 GARDEN PARK DR TOLEDO, OH US |
| Practice Office Telephone | 4194903711 |
| Mailing Address | 4042 GARDEN PARK DR TOLEDO, OH 436134043 US |
| Business Telephone | 4194903711 |
| Code | Practice | License No State |
|---|---|---|
| 3104A0625X PRIMARY | Nursing & Custodial Care Facilities Assisted Living Facility Assisted Living Facility: Assisted Living, Mental Illness Assisted Living Facility Assisted Living, Mental Illness Nursing & Custodial Care Facilities Assisted Living Facility | SN396250
OH |