Provider Demographics
NPI:1568530889
Name:NORTHERN OHIO CARE GIVERS LLC
Entity Type:Organization
Organization Name:NORTHERN OHIO CARE GIVERS LLC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-424-6773
Mailing Address - Street 1:77 WHITTLESEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-1450
Mailing Address - Country:US
Mailing Address - Phone:567-424-6773
Mailing Address - Fax:567-424-6783
Practice Address - Street 1:77 WHITTLESEY AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-1450
Practice Address - Country:US
Practice Address - Phone:567-424-6773
Practice Address - Fax:567-424-6783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2540889Medicaid