Healthcare Provider Details
I. General information
NPI: 1205541026
Provider Name (Legal Business Name): XPRESS HOMECARE AND HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/16/2023
Last Update Date: 01/16/2023
Certification Date: 01/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25701 N LAKELAND BLVD STE 103
EUCLID OH
44132-2436
US
IV. Provider business mailing address
25101 N LAKELAND BLVD UNIT 23223
EUCLID OH
44123-9525
US
V. Phone/Fax
- Phone: 216-303-0966
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 164W00000X |
| Taxonomy | Licensed Practical Nurse |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANEESAH
LEWIS
Title or Position: OWNER
Credential: LPN
Phone: 216-303-0966