Provider Demographics
NPI:1215524343
Name:SHELTERING ARMS HOME HEALTH
Entity type:Organization
Organization Name:SHELTERING ARMS HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:MS
Authorized Official - First Name:TAWONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:216-965-8107
Mailing Address - Street 1:5010 MAYFIELD RD STE 304
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2697
Mailing Address - Country:US
Mailing Address - Phone:216-801-9220
Mailing Address - Fax:
Practice Address - Street 1:5010 MAYFIELD RD STE 304
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2697
Practice Address - Country:US
Practice Address - Phone:216-801-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1447855507Medicaid