Healthcare Provider Details

I. General information

NPI: 1801580725
Provider Name (Legal Business Name): SIGNATURECARE HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 11/14/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 WARRENSVILLE CENTER RD #1
SOUTH EUCLID OH
44121
US

IV. Provider business mailing address

1481 WARRENSVILLE CENTER RD UPPR 1
SOUTH EUCLID OH
44121-2685
US

V. Phone/Fax

Practice location:
  • Phone: 216-417-4444
  • Fax: 216-291-5433
Mailing address:
  • Phone: 216-417-4444
  • Fax: 216-291-5433

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KELLE N SMITH POUGE
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 216-965-9613