Provider Demographics
NPI:1073226189
Name:LIFE LONG HOME CARE
Entity Type:Organization
Organization Name:LIFE LONG HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-431-5999
Mailing Address - Street 1:716 ANNAPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-1604
Mailing Address - Country:US
Mailing Address - Phone:330-431-5999
Mailing Address - Fax:
Practice Address - Street 1:716 ANNAPOLIS AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1604
Practice Address - Country:US
Practice Address - Phone:330-431-5999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services