Healthcare Provider Details

I. General information

NPI: 1912828229
Provider Name (Legal Business Name): HOME BOUND LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 PARK SIDE TRL
SOLON OH
44139-1160
US

IV. Provider business mailing address

5325 PARK SIDE TRL
SOLON OH
44139-1160
US

V. Phone/Fax

Practice location:
  • Phone: 216-539-6788
  • Fax:
Mailing address:
  • Phone: 216-539-6788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ROXANA YOUNG
Title or Position: NURSE
Credential: LPN
Phone: 216-965-6191