MEDICARE: HOME AWAY FROM HOME ADULT DAY 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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1790622256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME AWAY FROM HOME ADULT DAY CARE LLC

Provider Business Mailing Address
First Line	:	6034 RED OAK DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-1855
Country	:	US
Telephone Number	:	419-936-0226
Fax Number	:

Provider Business Practice Location Address
First Line	:	6034 RED OAK DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-1855
Country	:	US
Telephone Number	:	419-936-0226
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	KYNDRA N HAYES
Credential	:	RN
Telephone Number	:	419-936-0226

Provider Enumeration Date	:	05/01/2026
Last Update Date	:	05/01/2026

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