MEDICARE: STOUT SENIOR CARE

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	:	1316263072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STOUT SENIOR CARE

Provider Business Mailing Address
First Line	:	6118 WELSFORD CT
Second Line	:
City	:	MAUMEE
State	:	OH
Zip	:	43537-1329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7843 LAUREL AVE
Second Line	:
City	:	MADEIRA
State	:	OH
Zip	:	45243-2608
Country	:	US
Telephone Number	:	513-432-6468
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CAY MATEYKO STOUT
Credential	:
Telephone Number	:	419-350-8322

Provider Enumeration Date	:	04/20/2010
Last Update Date	:	04/20/2010

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Directions to “STOUT SENIOR CARE ” Practice Location

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