Provider Demographics
NPI:1821720905
Name:PTC HOMECARE WESTLAKE LLC
Entity Type:Organization
Organization Name:PTC HOMECARE WESTLAKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-534-4099
Mailing Address - Street 1:26202 DETROIT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2480
Mailing Address - Country:US
Mailing Address - Phone:440-534-4099
Mailing Address - Fax:
Practice Address - Street 1:26202 DETROIT RD STE 300
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2480
Practice Address - Country:US
Practice Address - Phone:440-534-4099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PTC HOMECARE OHIO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care