MEDICARE: CEDARLINE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1386503266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDARLINE HOME CARE, LLC

Provider Business Mailing Address
First Line	:	436 S MAIN ST
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-3258
Country	:	US
Telephone Number	:	517-939-9852
Fax Number	:

Provider Business Practice Location Address
First Line	:	436 S MAIN ST
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-3258
Country	:	US
Telephone Number	:	517-939-9852
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HANNAH FASUJI
Credential	:
Telephone Number	:	517-270-0354

Provider Enumeration Date	:	01/17/2026
Last Update Date	:	01/19/2026

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