MEDICARE: GOOD MOOD HEALTHCARE

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

General Provider Information

NPI Number	:	1245934876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD MOOD HEALTHCARE

Provider Business Mailing Address
First Line	:	3605 CEDARBROOK RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3046
Country	:	US
Telephone Number	:	216-552-6588
Fax Number	:

Provider Business Practice Location Address
First Line	:	3605 CEDARBROOK RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3046
Country	:	US
Telephone Number	:	216-552-6588
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	JAY MOODY
Credential	:
Telephone Number	:	216-855-2658

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	03/28/2023

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Directions to “GOOD MOOD HEALTHCARE ” Practice Location

Language	Start Address	Practice Location

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