MEDICARE: JUST LIKE FAMILEE III, INC

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	1618913	OH

General Provider Information

NPI Number	:	1962453563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUST LIKE FAMILEE III, INC

Provider Business Mailing Address
First Line	:	2234 E ENTERPRISE PKWY
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-2393
Country	:	US
Telephone Number	:	330-425-0220
Fax Number	:	330-425-0231

Provider Business Practice Location Address
First Line	:	2000 LEE RD
Second Line	:	SUITE 201
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2572
Country	:	US
Telephone Number	:	330-425-0220
Fax Number	:	330-425-0231

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. DELORES LOUISE KNIGHT
Credential	:	BA
Telephone Number	:	330-425-0220

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	12/19/2011

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