Healthcare Provider Details

I. General information

NPI: 1801404991
Provider Name (Legal Business Name): SWEET HOME HEALTHCARE OF OHIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2020
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7963 EUCLID AVE
CLEVELAND OH
44103-4226
US

IV. Provider business mailing address

1400 E 105TH ST STE 5
CLEVELAND OH
44106-1101
US

V. Phone/Fax

Practice location:
  • Phone: 216-415-5033
  • Fax: 888-467-5575
Mailing address:
  • Phone: 216-415-5033
  • Fax: 888-467-5575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP J KELLER
Title or Position: CFO
Credential:
Phone: 502-386-0074