Healthcare Provider Details

I. General information

NPI: 1245930635
Provider Name (Legal Business Name): LORETTA'S HELPING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5211 FLEET AVE
CLEVELAND OH
44105-3333
US

IV. Provider business mailing address

3871 E 53RD ST
CLEVELAND OH
44105-3317
US

V. Phone/Fax

Practice location:
  • Phone: 216-623-7959
  • Fax:
Mailing address:
  • Phone: 216-623-7959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: SHALONDA PUGH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 216-623-7959