Provider Demographics
NPI:1225525728
Name:REALCAREHOMECARE INC
Entity Type:Organization
Organization Name:REALCAREHOMECARE INC
Other - Org Name:REALCAREHOMECARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-534-4284
Mailing Address - Street 1:435 GYPSY LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1337
Mailing Address - Country:US
Mailing Address - Phone:330-534-4284
Mailing Address - Fax:330-534-4495
Practice Address - Street 1:435 GYPSY LN
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1337
Practice Address - Country:US
Practice Address - Phone:330-534-4284
Practice Address - Fax:330-534-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health