MEDICARE: SIGNATURECARE HOME HEALTH, 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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1184499808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIGNATURECARE HOME HEALTH, LLC

Provider Business Mailing Address
First Line	:	1481 WARRENSVILLE CENTER RD UPPR 1
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-2685
Country	:	US
Telephone Number	:	216-417-4444
Fax Number	:	216-291-5433

Provider Business Practice Location Address
First Line	:	1481 WARRENSVILLE CENTER RD UPPR 1
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-2685
Country	:	US
Telephone Number	:	216-417-4444
Fax Number	:	216-291-5433

Authorized Official
Title or Position	:	CEO
Name	:	KELLE SMITH POUGE
Credential	:
Telephone Number	:	216-965-9613

Provider Enumeration Date	:	11/22/2023
Last Update Date	:	12/18/2023

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