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NPI Code Detail

MEDICARE: OAKPARK HOMEHEALTH AGENCY LLC

MEDICARE: OAKPARK HOMEHEALTH AGENCY 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1780095331
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAKPARK HOMEHEALTH AGENCY LLC
Provider Business Mailing Address
First Line : 1012 PROSPECT AVE E APT 1025
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-1239
Country : US
Telephone Number : 216-233-9859
Fax Number :
Provider Business Practice Location Address
First Line : 1012 PROSPECT AVE E APT 1025
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-1239
Country : US
Telephone Number : 216-233-9859
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : DEREK E HOWZE
Credential : BBA
Telephone Number : 216-233-9859
Provider Enumeration Date : 05/16/2014
Last Update Date : 05/16/2014

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Directions to “OAKPARK HOMEHEALTH AGENCY LLC ” Practice Location

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