Provider Demographics
NPI:1912632845
Name:MAJESTIC HEART HOME CARE LLC
Entity Type:Organization
Organization Name:MAJESTIC HEART HOME CARE LLC
Other - Org Name:MAJESTIC HEART HOME CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-235-2707
Mailing Address - Street 1:17325 EUCLID AVE STE 3187
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1247
Mailing Address - Country:US
Mailing Address - Phone:216-731-1133
Mailing Address - Fax:216-920-7830
Practice Address - Street 1:17325 EUCLID AVE STE 3187
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1247
Practice Address - Country:US
Practice Address - Phone:216-731-1333
Practice Address - Fax:216-920-7830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health