MEDICARE: LIZZIES HOUSE SENIOR HOME CARE 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	385H00000X	Respite Care
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1326538794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIZZIES HOUSE SENIOR HOME CARE LLC

Provider Business Mailing Address
First Line	:	17325 EUCLID AVE STE 2172
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44112-1275
Country	:	US
Telephone Number	:	216-816-4188
Fax Number	:	216-242-6374

Provider Business Practice Location Address
First Line	:	48 ALPHA PARK
Second Line	:
City	:	HIGHLAND HTS
State	:	OH
Zip	:	44143-2208
Country	:	US
Telephone Number	:	216-816-4188
Fax Number	:	216-242-6374

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	SKYE G GRIGGS
Credential	:
Telephone Number	:	216-816-4188

Provider Enumeration Date	:	05/11/2018
Last Update Date	:	02/11/2025

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