Healthcare Provider Details

I. General information

NPI: 1124935259
Provider Name (Legal Business Name): CARING HEARTS SUPPORTING LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10923 CHURCHILL AVE
CLEVELAND OH
44106-1212
US

IV. Provider business mailing address

10923 CHURCHILL AVE
CLEVELAND OH
44106-1212
US

V. Phone/Fax

Practice location:
  • Phone: 216-926-5513
  • Fax:
Mailing address:
  • Phone: 216-926-5513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: HERMAN JACKSON
Title or Position: OWNER
Credential:
Phone: 216-926-5513