Healthcare Provider Details

I. General information

NPI: 1568211266
Provider Name (Legal Business Name): ESSENCE OF HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21203 FRANKLIN RD
MAPLE HEIGHTS OH
44137-2131
US

IV. Provider business mailing address

21203 FRANKLIN RD
MAPLE HEIGHTS OH
44137-2131
US

V. Phone/Fax

Practice location:
  • Phone: 216-339-4850
  • Fax:
Mailing address:
  • Phone: 216-339-4850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: AMANI SPICER
Title or Position: OWNER
Credential:
Phone: 216-339-4850