Provider Demographics
NPI:1346893013
Name:BLUEDOT CARES OF OHIO LLC
Entity Type:Organization
Organization Name:BLUEDOT CARES OF OHIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-827-6555
Mailing Address - Street 1:15707 DETROIT AVE STE 216
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3700
Mailing Address - Country:US
Mailing Address - Phone:440-827-6555
Mailing Address - Fax:
Practice Address - Street 1:1991 CROCKER RD STE 600
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-6976
Practice Address - Country:US
Practice Address - Phone:440-827-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care