Healthcare Provider Details

I. General information

NPI: 1700678455
Provider Name (Legal Business Name): HOME IN HEALTH HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6811 MAYFIELD RD APT 677
MAYFIELD HEIGHTS OH
44124-2222
US

IV. Provider business mailing address

6811 MAYFIELD RD APT 677
MAYFIELD HEIGHTS OH
44124-2222
US

V. Phone/Fax

Practice location:
  • Phone: 440-999-0134
  • Fax:
Mailing address:
  • Phone: 440-999-0134
  • 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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KYNDAL WILSON
Title or Position: CEO
Credential: RN
Phone: 440-999-0134