Provider Demographics
NPI:1063545705
Name:MY HOME HEALTH AGENCY
Entity type:Organization
Organization Name:MY HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:FRANCINE
Authorized Official - Last Name:BOASTEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:330-253-6368
Mailing Address - Street 1:947 MORNINGSTAR DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2252
Mailing Address - Country:US
Mailing Address - Phone:330-253-6368
Mailing Address - Fax:202-446-0836
Practice Address - Street 1:947 MORNINGSTAR DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2252
Practice Address - Country:US
Practice Address - Phone:330-253-6368
Practice Address - Fax:202-446-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health