Provider Demographics
NPI:1952047094
Name:SKILLED HOME HEALTH AGENCY LLC.
Entity Type:Organization
Organization Name:SKILLED HOME HEALTH AGENCY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-608-9064
Mailing Address - Street 1:2827 MULL AVE
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-2115
Mailing Address - Country:US
Mailing Address - Phone:330-608-8064
Mailing Address - Fax:234-466-8044
Practice Address - Street 1:2827 MULL AVE
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-2115
Practice Address - Country:US
Practice Address - Phone:330-608-8064
Practice Address - Fax:234-466-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health