Provider Demographics
NPI:1417619586
Name:DEVOTED FAMILY HOME CARE LLC
Entity Type:Organization
Organization Name:DEVOTED FAMILY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:216-225-4980
Mailing Address - Street 1:5165 SMITH RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-1752
Mailing Address - Country:US
Mailing Address - Phone:216-225-4980
Mailing Address - Fax:216-239-7015
Practice Address - Street 1:5165 SMITH RD STE 2
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-1752
Practice Address - Country:US
Practice Address - Phone:216-272-5610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0019043Medicaid