Provider Demographics
NPI:1922366806
Name:TOLEDO METRO HOUSING COMMUNITY DEVELOPMENT NETWORK
Entity Type:Organization
Organization Name:TOLEDO METRO HOUSING COMMUNITY DEVELOPMENT NETWORK
Other - Org Name:ICARE HOME & HEALTH CARE SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LORELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:419-508-1524
Mailing Address - Street 1:316 N MICHIGAN ST
Mailing Address - Street 2:414
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-5667
Mailing Address - Country:US
Mailing Address - Phone:419-508-1524
Mailing Address - Fax:419-241-2088
Practice Address - Street 1:316 N MICHIGAN ST
Practice Address - Street 2:414
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5667
Practice Address - Country:US
Practice Address - Phone:419-508-1524
Practice Address - Fax:419-241-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHM4805063Medicaid