Provider Demographics
NPI:1568026508
Name:XO HOME CARE
Entity Type:Organization
Organization Name:XO HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-530-0651
Mailing Address - Street 1:14855 BROADWAY AVE 100-2B
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-1147
Mailing Address - Country:US
Mailing Address - Phone:216-510-5943
Mailing Address - Fax:216-510-0034
Practice Address - Street 1:14855 BROADWAY AVE 100-2B
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1147
Practice Address - Country:US
Practice Address - Phone:216-510-5943
Practice Address - Fax:216-510-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0335357Medicaid