=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013732742
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOYAL HOMECARE SERVICES AND TRANSPORTATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2024
-----------------------------------------------------
Last Update Date | 11/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4941 E 86TH ST
-----------------------------------------------------
City | GARFIELD HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44125-2022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-854-3166
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4941 E 86TH ST
-----------------------------------------------------
City | GARFIELD HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44125-2022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-854-3166
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOO
-----------------------------------------------------
Name | MRS. AISHIA NAOMI WHITE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-854-3166
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------