Provider Demographics
NPI:1861376972
Name:DAVIS, TYRIA SUNSARAI (QMHS)
Entity type:Individual
Prefix:
First Name:TYRIA SUNSARAI
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 SHENANDOAH RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-1673
Mailing Address - Country:US
Mailing Address - Phone:419-469-4283
Mailing Address - Fax:
Practice Address - Street 1:1914 SHENANDOAH RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-1673
Practice Address - Country:US
Practice Address - Phone:419-469-4283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103K00000X, 172A00000X, 251C00000X, 251X00000X, 343900000X, 3747P1801X, 385H00000X, 385HR2050X, 385HR2060X, 385HR2055X
376J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No172A00000XOther Service ProvidersDriver
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports Brokerage
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No385H00000XRespite Care FacilityRespite Care
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child