MEDICARE: A LIFETIME OF LOVE

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	:	1619752656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A LIFETIME OF LOVE

Provider Business Mailing Address
First Line	:	1406 HARRISBURG RD NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44705-1863
Country	:	US
Telephone Number	:	330-937-1438
Fax Number	:

Provider Business Practice Location Address
First Line	:	1406 HARRISBURG RD NE
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44705-1863
Country	:	US
Telephone Number	:	330-937-1438
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. MERCEDES M BROWN
Credential	:	LPN
Telephone Number	:	330-937-1438

Provider Enumeration Date	:	08/28/2023
Last Update Date	:	08/28/2023

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Directions to “A LIFETIME OF LOVE ” Practice Location

Language	Start Address	Practice Location

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