MEDICARE: HOME ROOTS HEALTH CARE, INC.

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	:	1396558276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME ROOTS HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	5437 MAHONING AVE
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44515-2437
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6110 MAYFIELD RD UPPR
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-3207
Country	:	US
Telephone Number	:	330-990-0960
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	SASI KAZA
Credential	:
Telephone Number	:	330-990-0960

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	01/27/2025

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