Healthcare Provider Details

I. General information

NPI: 1760580237
Provider Name (Legal Business Name): CDC HOME CARE YOUNGSTOWN LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 SOUTHWESTERN RUN
YOUNGSTOWN OH
44514-3688
US

IV. Provider business mailing address

18720 CHAGRIN BLVD
SHAKER HEIGHTS OH
44122-4855
US

V. Phone/Fax

Practice location:
  • Phone: 866-533-0059
  • Fax:
Mailing address:
  • Phone: 216-295-7003
  • Fax: 216-295-7014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GAYLE A NEMECEK
Title or Position: COO
Credential:
Phone: 216-658-0458