Healthcare Provider Details

I. General information

NPI: 1649123514
Provider Name (Legal Business Name): PATRIOT CARE HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 LITTLE CHERYL DR
MC DERMOTT OH
45652-8998
US

IV. Provider business mailing address

314 LITTLE CHERYL DR
MC DERMOTT OH
45652-8998
US

V. Phone/Fax

Practice location:
  • Phone: 740-206-8815
  • Fax:
Mailing address:
  • Phone: 740-206-8815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACI MICHELE BOLAND
Title or Position: OWNER
Credential: RN
Phone: 740-206-8815