Provider Demographics
NPI:1194134767
Name:PLANET CARE HOME HEALTH SERVICES
Entity type:Organization
Organization Name:PLANET CARE HOME HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSTAMOV
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:440-229-5855
Mailing Address - Street 1:PO BOX 241517
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-8517
Mailing Address - Country:US
Mailing Address - Phone:440-229-5855
Mailing Address - Fax:440-448-4903
Practice Address - Street 1:5813 MAYFIELD RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44124-2932
Practice Address - Country:US
Practice Address - Phone:440-229-5855
Practice Address - Fax:440-448-4903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health