MEDICARE: FOUR HEIRS HOLDINGS 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1245199256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUR HEIRS HOLDINGS LLC

Provider Business Mailing Address
First Line	:	6018 PORSHA DR
Second Line	:
City	:	SYLVANIA
State	:	OH
Zip	:	43560-9220
Country	:	US
Telephone Number	:	419-973-3198
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007SMCCORD
Second Line	:	#1-8
City	:	HOLLAND
State	:	OH
Zip	:	43528
Country	:	US
Telephone Number	:	567-742-7330
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA MOSLEY
Credential	:
Telephone Number	:	419-973-3198

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “FOUR HEIRS HOLDINGS LLC ” Practice Location

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