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General NPI Number Information
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NPI Number | 1972395036
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Entity Type | Organization
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Legal Business Name | 1 PURE FAMILY HOMECARE LLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 12114 LENACRAVE AVE
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City | CLEVELAND
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State | OH
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Zip | 44105-4445
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Country | US
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Telephone | 216-541-0330
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Fax |
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Provider Business Mailing Address
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Address Line | 3702 LINDHOLM RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-5129
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Country | US
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Telephone | 216-541-0330
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBBIE CAYSON
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Credential |
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Telephone | 216-541-0330
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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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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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