MEDICARE: COMMITTED CARETAKERS 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	:	1760087084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMITTED CARETAKERS LLC

Provider Business Mailing Address
First Line	:	4225 MAYFIELD RD STE 201
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-3037
Country	:	US
Telephone Number	:	216-645-5425
Fax Number	:

Provider Business Practice Location Address
First Line	:	4225 MAYFIELD RD STE 201
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-3037
Country	:	US
Telephone Number	:	216-645-5425
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	DEANGELO GREEN
Credential	:
Telephone Number	:	216-645-5425

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	12/17/2023

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Directions to “COMMITTED CARETAKERS LLC ” Practice Location

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