Healthcare Provider Details

I. General information

NPI: 1588476543
Provider Name (Legal Business Name): WAITMAN FAMILY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20545 CENTER RIDGE RD STE 410
ROCKY RIVER OH
44116-3428
US

IV. Provider business mailing address

20545 CENTER RIDGE RD STE 410
ROCKY RIVER OH
44116-3428
US

V. Phone/Fax

Practice location:
  • Phone: 440-890-2245
  • Fax: 440-890-2245
Mailing address:
  • Phone: 440-890-2245
  • Fax: 440-890-2245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARA WAITMAN
Title or Position: OWNER
Credential:
Phone: 810-516-2222