Provider Demographics
NPI:1003347659
Name:RICHTELL HOME HEALTHCARE AGENCY,LLC
Entity Type:Organization
Organization Name:RICHTELL HOME HEALTHCARE AGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAINE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:419-280-0962
Mailing Address - Street 1:535 SPRINGWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528
Mailing Address - Country:US
Mailing Address - Phone:419-280-0962
Mailing Address - Fax:
Practice Address - Street 1:535 SPRINGWOOD LN
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-7890
Practice Address - Country:US
Practice Address - Phone:419-280-0962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.377629251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health