Provider Demographics
NPI:1194075606
Name:SUCCOR HOME HEALTH CARE
Entity type:Organization
Organization Name:SUCCOR HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-348-3931
Mailing Address - Street 1:2139 PEBBLE CREEK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-3028
Mailing Address - Country:US
Mailing Address - Phone:330-348-3931
Mailing Address - Fax:
Practice Address - Street 1:2139 PEBBLE CREEK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-3028
Practice Address - Country:US
Practice Address - Phone:330-348-3931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health