MEDICARE: MITIS HOME 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1912835034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MITIS HOME CARE LLC

Provider Business Mailing Address
First Line	:	546 OLD FRANKSTOWN RD UNIT A
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-1087
Country	:	US
Telephone Number	:	412-302-7954
Fax Number	:

Provider Business Practice Location Address
First Line	:	546 OLD FRANKSTOWN RD UNIT A
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-1087
Country	:	US
Telephone Number	:	412-302-7954
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KHUMI CLENNON
Credential	:
Telephone Number	:	412-302-7954

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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Directions to “MITIS HOME CARE LLC ” Practice Location

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