Healthcare Provider Details

I. General information

NPI: 1275248684
Provider Name (Legal Business Name): DLL HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2023
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 KELLY AVE
AKRON OH
44306-2816
US

IV. Provider business mailing address

932 KELLY AVE
AKRON OH
44306-2816
US

V. Phone/Fax

Practice location:
  • Phone: 330-962-9944
  • Fax:
Mailing address:
  • Phone: 330-962-9944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: ALICEMAE LIDGE
Title or Position: PARTNER/DOO
Credential:
Phone: 330-962-9944