Healthcare Provider Details

I. General information

NPI: 1245030808
Provider Name (Legal Business Name): LOUISA'S HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 04/26/2025
Certification Date: 04/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 E 14TH ST
LIMA OH
45804-2421
US

IV. Provider business mailing address

11051 AUTUMN LN
FOSTORIA OH
44830-3309
US

V. Phone/Fax

Practice location:
  • Phone: 419-934-5988
  • Fax: 419-934-5988
Mailing address:
  • Phone: 419-934-5988
  • Fax: 419-934-5988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1699012898
Identifier TypeMEDICAID
Identifier StateNV
Identifier Issuer

VIII. Authorized Official

Name: MR. ANDRE WILLIAMS
Title or Position: CEO
Credential: LPCC,LCPC
Phone: 419-934-5988