Healthcare Provider Details
I. General information
NPI: 1942098009
Provider Name (Legal Business Name): FIFTH AND HEART HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2025
Last Update Date: 08/25/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1188 BELL RD STE 105
CHAGRIN FALLS OH
44022-6101
US
IV. Provider business mailing address
1188 BELL RD STE 105
CHAGRIN FALLS OH
44022-6101
US
V. Phone/Fax
- Phone: 216-353-2346
- Fax:
- Phone: 440-375-3201
- Fax: 440-375-3252
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174200000X |
| Taxonomy | Meals Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MCKENZIE
MISHLER
Title or Position: ADMIN
Credential:
Phone: 440-375-3201