Healthcare Provider Details

I. General information

NPI: 1972507200
Provider Name (Legal Business Name): ASHTABULA REGIONAL HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 LAKE AVE STE 2
ASHTABULA OH
44004-3466
US

IV. Provider business mailing address

PO BOX 1428
ASHTABULA OH
44005-1428
US

V. Phone/Fax

Practice location:
  • Phone: 440-992-4663
  • Fax: 440-992-0687
Mailing address:
  • Phone: 440-992-4663
  • Fax: 440-992-0687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNA
License Number StateOH

VIII. Authorized Official

Name: CONNIE FOX
Title or Position: ACCOUNTS SUPERVISOR
Credential:
Phone: 440-997-6257