MEDICARE: KIM GLOVER HHA

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	:	1467259606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM GLOVER HHA

Provider Business Mailing Address
First Line	:	960 E 143RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3408
Country	:	US
Telephone Number	:	404-707-5405
Fax Number	:

Provider Business Practice Location Address
First Line	:	960 E 143RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3408
Country	:	US
Telephone Number	:	404-707-5405
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	02/26/2025

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