MEDICARE: RENAISSANCE HOME HEALTH CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1073812202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAISSANCE HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	5311 NORTHFIELD RD
Second Line	:	212
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-1188
Country	:	US
Telephone Number	:	216-662-8729
Fax Number	:	216-662-8849

Provider Business Practice Location Address
First Line	:	5311 NORTHFIELD RD
Second Line	:	212
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-1188
Country	:	US
Telephone Number	:	216-662-8729
Fax Number	:	216-662-8849

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LANETTA MASSEY
Credential	:
Telephone Number	:	216-662-8729

Provider Enumeration Date	:	03/28/2011
Last Update Date	:	03/28/2011

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