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General NPI Number Information
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NPI Number | 1063655975
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Entity Type | Organization
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Legal Business Name | PLATINUM HOME HEALTH CARE SERVICES.
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 17626 LOMOND BLVD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-5241
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Country | US
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Telephone | 216-280-0584
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Fax | 216-295-0102
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Provider Business Mailing Address
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Address Line | 17626 LOMOND BLVD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-5241
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Country | US
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Telephone | 216-280-0584
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Fax | 216-295-0102
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Authorized Official
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Title or Position | CEO
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Name | MRS. LAWANNA ANITA PORTER
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Credential | REGISTERED NURSE
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Telephone | 216-280-0584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 337958
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 337958
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 337958
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 337958
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License Number State | OH
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