Healthcare Provider Details

I. General information

NPI: 1649099565
Provider Name (Legal Business Name): AMOR HOMECARE OF OHIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 E 45TH ST
CLEVELAND OH
44127-1088
US

IV. Provider business mailing address

11027 106TH ST
OZONE PARK NY
11417-2614
US

V. Phone/Fax

Practice location:
  • Phone: 917-226-0509
  • Fax:
Mailing address:
  • Phone: 917-226-0509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AGUSTIN PRADO
Title or Position: ADMINISTRATOR
Credential:
Phone: 917-226-0509