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General NPI Number Information
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NPI Number | 1205599123
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Entity Type | Organization
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Legal Business Name | BRAXTON HOME HEALTHCARE
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 7015 CENTER ST
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City | MENTOR
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State | OH
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Zip | 44060-4933
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Country | US
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Telephone | 440-209-2790
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Fax |
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Provider Business Mailing Address
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Address Line | 7015 CENTER ST
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City | MENTOR
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State | OH
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Zip | 44060-4933
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Country | US
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Telephone | 440-209-2790
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Fax |
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Authorized Official
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Title or Position | OWER
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Name | ANDREA KASEDA
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Credential |
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Telephone | 440-209-2790
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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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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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