MEDICARE: JONES LUXE HOMECARE

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	:	1174466437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONES LUXE HOMECARE

Provider Business Mailing Address
First Line	:	1898 E 66TH ST UNIT 2
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-3926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1898 E 66TH ST UNIT 2
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-3926
Country	:	US
Telephone Number	:	216-924-0446
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NICKISHA JOHNSON
Credential	:
Telephone Number	:	216-924-0446

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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