MEDICARE: CARE CONNECT HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1104536622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE CONNECT HOME CARE LLC

Provider Business Mailing Address
First Line	:	3817 MONTEVISTA RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44121-1612
Country	:	US
Telephone Number	:	216-315-9006
Fax Number	:

Provider Business Practice Location Address
First Line	:	3817 MONTEVISTA RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44121-1612
Country	:	US
Telephone Number	:	216-315-9006
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHKIRA HOLMES
Credential	:	RN
Telephone Number	:	216-315-9006

Provider Enumeration Date	:	11/28/2022
Last Update Date	:	11/28/2022

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