=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215524343
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHELTERING ARMS HOME HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2020
-----------------------------------------------------
Last Update Date | 12/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5010 MAYFIELD RD STE 304
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44124-2697
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-801-9220
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5010 MAYFIELD RD STE 304
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44124-2697
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-801-9220
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DON
-----------------------------------------------------
Name | MS. TAWONDA SMITH
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 216-965-8107
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------