Healthcare Provider Details

I. General information

NPI: 1740887371
Provider Name (Legal Business Name): WEST GATE HOME SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1991 CROCKER RD STE 600
WESTLAKE OH
44145-6976
US

IV. Provider business mailing address

715 LAKE TRL
AURORA OH
44202-8478
US

V. Phone/Fax

Practice location:
  • Phone: 440-695-3567
  • Fax:
Mailing address:
  • Phone: 330-732-7075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER HEGELE
Title or Position: MANAGING MEMBER
Credential:
Phone: 440-695-3567