MEDICARE: AXXISCARE HOME HEALTH 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

General Provider Information

NPI Number	:	1518407881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AXXISCARE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	1420 RICHMOND RD
Second Line	:	M-1
City	:	CLEVELAND
State	:	OH
Zip	:	44124-2459
Country	:	US
Telephone Number	:	614-592-3032
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 RICHMOND RD
Second Line	:	M-1
City	:	CLEVELAND
State	:	OH
Zip	:	44118
Country	:	US
Telephone Number	:	614-592-3032
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. YUSUF FARAH
Credential	:
Telephone Number	:	614-592-3032

Provider Enumeration Date	:	03/06/2017
Last Update Date	:	03/06/2017

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