=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811395510
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLEARPATH HOME HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2014
-----------------------------------------------------
Last Update Date | 12/11/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 450 GRANT ST SUITE 220
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44311-1183
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-784-2162
-----------------------------------------------------
Fax | 330-784-2197
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 450 GRANT ST SUITE 220
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44311-1183
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-784-2162
-----------------------------------------------------
Fax | 330-784-2197
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ANTHONY LANCIANESE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 330-784-2162
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 2072545
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------