Provider Demographics
NPI:1417522087
Name:ALTERCARE HOME HEALTH LLC
Entity type:Organization
Organization Name:ALTERCARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:419-755-1999
Mailing Address - Street 1:PO BOX 823
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44901-0823
Mailing Address - Country:US
Mailing Address - Phone:567-274-7176
Mailing Address - Fax:419-755-1959
Practice Address - Street 1:378 PARK AVE W
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3116
Practice Address - Country:US
Practice Address - Phone:419-755-1999
Practice Address - Fax:419-755-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health