=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710713169
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING COVE HOME HEALTH CARE AGENCY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2024
-----------------------------------------------------
Last Update Date | 09/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1025 S BROADWAY ST STE 403
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44311-2340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-249-7007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 675 WOLF LEDGES PKWY UNIT 2757
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44309-9125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-249-7007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | LAKITA MERRINER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 440-249-7007
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------