Healthcare Provider Details

I. General information

NPI: 1942825534
Provider Name (Legal Business Name): PORSCHA'S HEART TO HEART HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 AUBURN DR STE 200
BEACHWOOD OH
44122-4328
US

IV. Provider business mailing address

2000 AUBURN DR STE 200
BEACHWOOD OH
44122-4328
US

V. Phone/Fax

Practice location:
  • Phone: 440-879-7244
  • Fax:
Mailing address:
  • Phone: 440-879-7244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: PORSCHA LUSK
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 216-456-1450