Provider Demographics
NPI:1093009771
Name:PREMIER CAREGIVERS OF NORTHERN OHIO INC.
Entity Type:Organization
Organization Name:PREMIER CAREGIVERS OF NORTHERN OHIO INC.
Other - Org Name:HEART & HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMENDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-877-8900
Mailing Address - Street 1:8336 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-4820
Mailing Address - Country:US
Mailing Address - Phone:330-877-8900
Mailing Address - Fax:330-877-9400
Practice Address - Street 1:8336 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-4820
Practice Address - Country:US
Practice Address - Phone:330-877-8900
Practice Address - Fax:330-877-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0082183Medicaid