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General NPI Number Information
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NPI Number | 1639063977
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Entity Type | Organization
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Legal Business Name | ONE HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 159 CROCKER PARK BLVD FL 4
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City | WESTLAKE
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State | OH
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Zip | 44145-8131
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Country | US
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Telephone | 513-468-1028
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Fax | 516-468-1028
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Provider Business Mailing Address
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Address Line | 159 CROCKER PARK BLVD FL 4
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City | WESTLAKE
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State | OH
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Zip | 44145-8131
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Country | US
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Telephone | 513-468-1028
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Fax | 516-468-1028
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Authorized Official
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Title or Position | PRESIDENT, ALT ADMIN
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Name | NATAVAN REZAKOV
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Credential |
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Telephone | 513-468-1028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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