Healthcare Provider Details

I. General information

NPI: 1427933324
Provider Name (Legal Business Name): DOMINI HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29300 EUCLID AVE STE 200
WICKLIFFE OH
44092-1957
US

IV. Provider business mailing address

PO BOX 39022
NORTH RIDGEVILLE OH
44039-0022
US

V. Phone/Fax

Practice location:
  • Phone: 216-264-9598
  • Fax:
Mailing address:
  • Phone: 216-253-4917
  • Fax:

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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: SIMONE N WOODS
Title or Position: OWNER
Credential: RN
Phone: 216-253-4917