MEDICARE: ASPEN HOME HEALTH 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	:	1841856804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	20033 DETROIT RD STE H
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-2400
Country	:	US
Telephone Number	:	813-299-2148
Fax Number	:

Provider Business Practice Location Address
First Line	:	20033 DETROIT RD STE H
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-2400
Country	:	US
Telephone Number	:	813-299-2148
Fax Number	:

Authorized Official
Title or Position	:	NURSE CONSULTANT
Name	:	BERNARD SPOONER
Credential	:	RN
Telephone Number	:	139-927-8678

Provider Enumeration Date	:	05/15/2019
Last Update Date	:	05/15/2019

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