Provider Demographics
NPI:1275097818
Name:SUBURBAN HOME HEALTHCARE
Entity Type:Organization
Organization Name:SUBURBAN HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUANETTA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:HUGHES-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:216-296-4485
Mailing Address - Street 1:14217 ASHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2855
Mailing Address - Country:US
Mailing Address - Phone:216-296-4485
Mailing Address - Fax:
Practice Address - Street 1:14217 ASHWOOD RD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-2855
Practice Address - Country:US
Practice Address - Phone:216-296-4485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care