MEDICARE: GOOD HANDS RELIABLE 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	251E00000X	Home Health Agency	201509000034	OH

General Provider Information

NPI Number	:	1477949980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD HANDS RELIABLE HOME CARE LLC

Provider Business Mailing Address
First Line	:	503 E 200TH ST STE 102
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44119-1575
Country	:	US
Telephone Number	:	216-481-7505
Fax Number	:

Provider Business Practice Location Address
First Line	:	503 E 200TH ST STE 102
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44119-1562
Country	:	US
Telephone Number	:	216-481-7505
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RONISHA SPARKS
Credential	:
Telephone Number	:	216-481-7505

Provider Enumeration Date	:	04/10/2015
Last Update Date	:	04/10/2015

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