=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114671542
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME HELPERS OF CLEVELAND
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2022
-----------------------------------------------------
Last Update Date | 02/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1586 E 84TH ST
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44103-3412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-376-3499
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1586 E 84TH ST
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44103-3412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-376-3499
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DACIA K LOVE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-376-3499
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------