MEDICARE: WELLSBROOKE CERTIFIED HOME HEALTH CARE, INC

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	:	1265876593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSBROOKE CERTIFIED HOME HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	830 W SOUTH BOUNDARY ST
Second Line	:	SUITE C
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-5238
Country	:	US
Telephone Number	:	419-931-9930
Fax Number	:	419-931-9931

Provider Business Practice Location Address
First Line	:	830 W SOUTH BOUNDARY ST
Second Line	:	SUITE C
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-5238
Country	:	US
Telephone Number	:	419-931-9930
Fax Number	:	419-931-9931

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. CHERYL NAGEL
Credential	:
Telephone Number	:	419-931-9930

Provider Enumeration Date	:	04/17/2013
Last Update Date	:	04/08/2015

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