Healthcare Provider Details

I. General information

NPI: 1548972797
Provider Name (Legal Business Name): LOYALTY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2022
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 COUTANT AVE
LAKEWOOD OH
44107-5114
US

IV. Provider business mailing address

19525 HILLIARD BLVD UNIT 16173
ROCKY RIVER OH
44116-4706
US

V. Phone/Fax

Practice location:
  • Phone: 216-287-2601
  • Fax:
Mailing address:
  • Phone: 216-287-2601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DARTHENA ANNETTE CULPEPPER
Title or Position: OWNER
Credential:
Phone: 216-287-2601