Provider Demographics
NPI:1790043743
Name:ARBOR HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:ARBOR HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS-ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:EDCAGS,MED, BS
Authorized Official - Phone:330-865-5744
Mailing Address - Street 1:1692 MERRIMAN RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-9002
Mailing Address - Country:US
Mailing Address - Phone:330-865-5744
Mailing Address - Fax:330-865-5740
Practice Address - Street 1:1692 MERRIMAN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-9002
Practice Address - Country:US
Practice Address - Phone:330-865-5744
Practice Address - Fax:330-865-5740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7711042OtherHCBS WAIVER & SUPPORTED LIVING PROVIDER
OH227654037Medicaid