Healthcare Provider Details

I. General information

NPI: 1669319000
Provider Name (Legal Business Name): COSMO CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 COMPASS WEST DR
YOUNGSTOWN OH
44515-3440
US

IV. Provider business mailing address

PO BOX 4442
YOUNGSTOWN OH
44515-0442
US

V. Phone/Fax

Practice location:
  • Phone: 330-717-3351
  • Fax:
Mailing address:
  • Phone: 330-717-3351
  • Fax: 330-717-3351

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: KANISHA TEEMER
Title or Position: OWNWER
Credential: WARREN
Phone: 330-717-3351