Healthcare Provider Details

I. General information

NPI: 1851785570
Provider Name (Legal Business Name): A 1 CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3504 GLENWOOD BLVD
REMINDERVILLE OH
44202-9062
US

IV. Provider business mailing address

3504 GLENWOOD BLVD
REMINDERVILLE OH
44202-9062
US

V. Phone/Fax

Practice location:
  • Phone: 216-855-7775
  • Fax:
Mailing address:
  • Phone: 216-855-7775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberRN.363895
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberRN.363895
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberRN.363895
License Number StateOH

VIII. Authorized Official

Name: KETURA JACKSON
Title or Position: PRESIDENT
Credential: RN
Phone: 216-855-7775