MEDICARE: HERITAGE HOME HEALTH CARE AGENCY OF CLEVELAND HEIGHTS 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	:	1477831162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERITAGE HOME HEALTH CARE AGENCY OF CLEVELAND HEIGHTS INC

Provider Business Mailing Address
First Line	:	2490 LEE BLVD
Second Line	:	SUITE 314
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1268
Country	:	US
Telephone Number	:	216-371-9526
Fax Number	:	216-371-9527

Provider Business Practice Location Address
First Line	:	2490 LEE BLVD
Second Line	:	SUITE 314
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1268
Country	:	US
Telephone Number	:	216-371-9526
Fax Number	:	216-371-9527

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. QUEEN E WARD
Credential	:
Telephone Number	:	216-371-9526

Provider Enumeration Date	:	07/28/2011
Last Update Date	:	08/25/2011

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