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General NPI Number Information
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NPI Number | 1174205421
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Entity Type | Organization
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Legal Business Name | PR HOMECARE LLC
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 2230 COLLINGWOOD BLVD
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City | TOLEDO
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State | OH
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Zip | 43620-1190
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Country | US
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Telephone | 313-826-2693
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Fax |
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Provider Business Mailing Address
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Address Line | 596 HYATT LN
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City | TOLEDO
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State | OH
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Zip | 43604-8555
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Country | US
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Telephone | 313-826-2693
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | RACHEL M MCCLELLAN
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Credential |
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Telephone | 313-826-2693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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