Provider Demographics
NPI:1669672846
Name:HOMETECH HEALTHCARE SERVICES , LLC
Entity Type:Organization
Organization Name:HOMETECH HEALTHCARE SERVICES , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-832-8834
Mailing Address - Street 1:18402 SCOTTSDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6470
Mailing Address - Country:US
Mailing Address - Phone:216-295-9120
Mailing Address - Fax:216-295-9124
Practice Address - Street 1:18402 SCOTTSDALE BLVD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-6470
Practice Address - Country:US
Practice Address - Phone:216-295-9120
Practice Address - Fax:216-295-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health