Healthcare Provider Details

I. General information

NPI: 1770398158
Provider Name (Legal Business Name): YELLOW BRICK HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 FITCH RD
OLMSTED TWP OH
44138-1430
US

IV. Provider business mailing address

7600 FITCH RD
OLMSTED TWP OH
44138-1430
US

V. Phone/Fax

Practice location:
  • Phone: 216-235-3651
  • Fax:
Mailing address:
  • Phone: 216-235-3651
  • 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:

VIII. Authorized Official

Name: ANTHONY CARABALLO
Title or Position: DOO
Credential:
Phone: 216-235-3651