=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437764909
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NOBLE HOME CARE SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2020
-----------------------------------------------------
Last Update Date | 09/11/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4895 HAWLEY DR
-----------------------------------------------------
City | GENEVA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44041-9747
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-844-0812
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4895 HAWLEY DR
-----------------------------------------------------
City | GENEVA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44041-9747
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR/PRESIDENT
-----------------------------------------------------
Name | CARA LAUTANEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 440-812-4798
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------