MEDICARE: OUR PLACE 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	:	1275485823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUR PLACE LLC

Provider Business Mailing Address
First Line	:	3709 W 117TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5276
Country	:	US
Telephone Number	:	216-200-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	3709 W 117TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5276
Country	:	US
Telephone Number	:	216-200-2424
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TRISHA JOHNSON
Credential	:
Telephone Number	:	216-200-2424

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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Directions to “OUR PLACE LLC ” Practice Location

Language	Start Address	Practice Location

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