MEDICARE: STRONG TOWER LIVING AT HOME 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1699483966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRONG TOWER LIVING AT HOME LLC

Provider Business Mailing Address
First Line	:	4977 PENNY LN
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-5417
Country	:	US
Telephone Number	:	216-855-7692
Fax Number	:

Provider Business Practice Location Address
First Line	:	3676 E 118TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-2558
Country	:	US
Telephone Number	:	216-855-7692
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JEROME CASTLEBERRY SR.
Credential	:
Telephone Number	:	216-855-7692

Provider Enumeration Date	:	11/07/2022
Last Update Date	:	11/07/2022

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Directions to “STRONG TOWER LIVING AT HOME LLC ” Practice Location

Language	Start Address	Practice Location

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