Provider Demographics
NPI:1639548571
Name:HOME HEALTH SPECIALIZING WITH PEDIATRICS
Entity Type:Organization
Organization Name:HOME HEALTH SPECIALIZING WITH PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADNERIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSARIO-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:440-752-5250
Mailing Address - Street 1:2080 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-1919
Mailing Address - Country:US
Mailing Address - Phone:440-752-5250
Mailing Address - Fax:
Practice Address - Street 1:2080 E 30TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1919
Practice Address - Country:US
Practice Address - Phone:440-752-5250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN139557251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care