Healthcare Provider Details

I. General information

NPI: 1023056579
Provider Name (Legal Business Name): LAURIE ANN HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 MILTON BLVD
NEWTON FALLS OH
44444-8746
US

IV. Provider business mailing address

2200 MILTON BLVD
NEWTON FALLS OH
44444-8746
US

V. Phone/Fax

Practice location:
  • Phone: 330-872-7512
  • Fax: 330-872-3429
Mailing address:
  • Phone: 330-872-7512
  • Fax: 330-872-3429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number34184770
License Number StateOH

VIII. Authorized Official

Name: MRS. MARILYN MYERS
Title or Position: DIRECTOR OF NURSING
Credential: RN
Phone: 330-872-7512