Healthcare Provider Details

I. General information

NPI: 1457241291
Provider Name (Legal Business Name): HEART FILLED HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5285 NORTHFIELD RD
BEDFORD HTS OH
44146-1131
US

IV. Provider business mailing address

PO BOX 22118
BEACHWOOD OH
44122-0118
US

V. Phone/Fax

Practice location:
  • Phone: 216-551-1849
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JETHEL WARE III
Title or Position: PRESIDENT
Credential:
Phone: 216-551-1849