MEDICARE: HOME HEALTH VETERANS 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	:	1750732384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME HEALTH VETERANS LLC

Provider Business Mailing Address
First Line	:	3431 LEE RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-3649
Country	:	US
Telephone Number	:	440-823-2232
Fax Number	:

Provider Business Practice Location Address
First Line	:	3431 LEE RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-3649
Country	:	US
Telephone Number	:	440-823-2232
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW BANKS
Credential	:
Telephone Number	:	517-862-9418

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	06/24/2016

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