Healthcare Provider Details

I. General information

NPI: 1972419513
Provider Name (Legal Business Name): PUREWELL HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35410 RIDGE RD
WILLOUGHBY OH
44094-4145
US

IV. Provider business mailing address

35410 RIDGE RD
WILLOUGHBY OH
44094-4145
US

V. Phone/Fax

Practice location:
  • Phone: 440-669-8595
  • Fax:
Mailing address:
  • Phone: 440-669-8595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: NAUTICA MONTE KASEDA
Title or Position: OWNER
Credential: RN
Phone: 440-669-8595