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General NPI Number Information
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NPI Number | 1053080226
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Entity Type | Organization
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Legal Business Name | FANCY HOME CARE SERVICES
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Dates
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Enumeration Date | 09/10/2021
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 15375 HOLLAND RD
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City | BROOKPARK
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State | OH
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Zip | 44142-3341
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Country | US
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Telephone | 216-338-8996
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Fax |
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Provider Business Mailing Address
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Address Line | 15375 HOLLAND RD
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City | BROOKPARK
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State | OH
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Zip | 44142-3341
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Country | US
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Telephone | 216-338-8996
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Fax |
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Authorized Official
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Title or Position | OWER
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Name | SHARNERRA ADAMS
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Credential | RN
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Telephone | 440-420-5110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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