Provider Demographics
NPI:1821310822
Name:MULTICARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:MULTICARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-731-8900
Mailing Address - Street 1:27691 EUCLID AVE
Mailing Address - Street 2:B-1
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3550
Mailing Address - Country:US
Mailing Address - Phone:216-731-8900
Mailing Address - Fax:216-731-8972
Practice Address - Street 1:27691 EUCLID AVE
Practice Address - Street 2:B-1
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3550
Practice Address - Country:US
Practice Address - Phone:216-731-8900
Practice Address - Fax:216-731-8972
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MULTICARE HEALTH & EDUCATIONL SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2015563Medicaid