Provider Demographics
NPI:1548762305
Name:AHAVA HOME CARE
Entity Type:Organization
Organization Name:AHAVA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-658-9813
Mailing Address - Street 1:5333 NORTHFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1186
Mailing Address - Country:US
Mailing Address - Phone:440-658-9813
Mailing Address - Fax:
Practice Address - Street 1:5333 NORTHFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1186
Practice Address - Country:US
Practice Address - Phone:440-658-9813
Practice Address - Fax:440-658-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0297117Medicaid