Healthcare Provider Details

I. General information

NPI: 1104286947
Provider Name (Legal Business Name): ACHIEVE HOME CARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10333 NORTHFIELD RD SUITE 74E
NORTHFIELD OH
44067-1467
US

IV. Provider business mailing address

10333 NORTHFIELD RD SUITE 74E
NORTHFIELD OH
44067-1467
US

V. Phone/Fax

Practice location:
  • Phone: 216-857-2249
  • Fax:
Mailing address:
  • Phone: 216-857-2249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: TEKISHA DIRRELLE WIMBUSH
Title or Position: PRESIDENT
Credential:
Phone: 216-857-2249