Healthcare Provider Details

I. General information

NPI: 1639534639
Provider Name (Legal Business Name): ERIN JOYS HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2015
Last Update Date: 12/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9613 TABERNA LN
OLMSTED TWP OH
44138-4260
US

IV. Provider business mailing address

9613 TABERNA LN
OLMSTED TWP OH
44138-4260
US

V. Phone/Fax

Practice location:
  • Phone: 330-614-4093
  • Fax:
Mailing address:
  • Phone: 330-614-4093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2832457
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name: MS. ERIN JOY MACAIONE
Title or Position: OWNER
Credential: LPN
Phone: 330-614-4093