MEDICARE: SACRED HEARTS

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	:	1225499155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRED HEARTS

Provider Business Mailing Address
First Line	:	10116 RICHLAND AVE
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-1605
Country	:	US
Telephone Number	:	216-276-3499
Fax Number	:

Provider Business Practice Location Address
First Line	:	10116 RICHLAND AVE
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-1605
Country	:	US
Telephone Number	:	216-276-3499
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	MS. DANA L STALLWORTH
Credential	:
Telephone Number	:	216-276-3499

Provider Enumeration Date	:	03/20/2016
Last Update Date	:	03/20/2016

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Directions to “SACRED HEARTS ” Practice Location

Language	Start Address	Practice Location

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