Provider Demographics
NPI:1639063977
Name:ONE HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:ONE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, ALT ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:NATAVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REZAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-468-1028
Mailing Address - Street 1:159 CROCKER PARK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-8131
Mailing Address - Country:US
Mailing Address - Phone:513-468-1028
Mailing Address - Fax:516-468-1028
Practice Address - Street 1:159 CROCKER PARK BLVD FL 4
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-8131
Practice Address - Country:US
Practice Address - Phone:513-468-1028
Practice Address - Fax:516-468-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care