Provider Demographics
NPI:1154869709
Name:RELIABLE COMMUNITY CARE
Entity type:Organization
Organization Name:RELIABLE COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERS BETHUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-414-8890
Mailing Address - Street 1:543 SHAWNEE LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3459
Mailing Address - Country:US
Mailing Address - Phone:216-414-8890
Mailing Address - Fax:
Practice Address - Street 1:543 SHAWNEE LN
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-3459
Practice Address - Country:US
Practice Address - Phone:216-414-8890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0245209Medicaid