MEDICARE: ENAMOR 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

General Provider Information

NPI Number	:	1558117481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENAMOR HOME CARE LLC

Provider Business Mailing Address
First Line	:	16970 LIBBY RD
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-1310
Country	:	US
Telephone Number	:	440-447-7872
Fax Number	:

Provider Business Practice Location Address
First Line	:	16970 LIBBY RD
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-1310
Country	:	US
Telephone Number	:	440-447-7872
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BREONA PRINCE
Credential	:
Telephone Number	:	440-447-7872

Provider Enumeration Date	:	04/30/2024
Last Update Date	:	04/30/2024

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