MEDICARE: IN HOME HEALTH 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1700838661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	333 N SUMMIT ST
Second Line	:	ATTN: DEAN SHIPMAN
City	:	TOLEDO
State	:	OH
Zip	:	43604-1531
Country	:	US
Telephone Number	:	419-254-7841
Fax Number	:	419-252-6448

Provider Business Practice Location Address
First Line	:	2100 SANDERS ROAD
Second Line	:	SUITE 100
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-6199
Country	:	US
Telephone Number	:	847-272-7338
Fax Number	:	847-272-7380

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. MARTIN D ALLEN
Credential	:
Telephone Number	:	419-254-5734

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	01/31/2022

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