Provider Demographics
NPI:1376745430
Name:SPECTRUM HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SPECTRUM HOME HEALTH CARE, LLC
Other - Org Name:CHARAK HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:ABDILLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:216-206-4916
Mailing Address - Street 1:12395 MCCRACKEN RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2967
Mailing Address - Country:US
Mailing Address - Phone:216-206-4916
Mailing Address - Fax:216-206-4935
Practice Address - Street 1:14055 CEDAR RD STE 306
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44118
Practice Address - Country:US
Practice Address - Phone:216-206-4916
Practice Address - Fax:216-206-4935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health