MEDICARE: SMART HEART HOME CARE LLC

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	:	1659948016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMART HEART HOME CARE LLC

Provider Business Mailing Address
First Line	:	2057 W 99TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-3603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2057 W 99TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-3603
Country	:	US
Telephone Number	:	216-410-3009
Fax Number	:

Authorized Official
Title or Position	:	LPN
Name	:	MISS WALNEISHA COLLINS
Credential	:
Telephone Number	:	216-410-3009

Provider Enumeration Date	:	06/04/2021
Last Update Date	:	06/04/2021

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Directions to “SMART HEART HOME CARE LLC ” Practice Location

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