Provider Demographics
NPI:1528682150
Name:HOMESTEAD HOSPICE OF OHIO, LLC
Entity type:Organization
Organization Name:HOMESTEAD HOSPICE OF OHIO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:KLEMENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-704-6547
Mailing Address - Street 1:150 4TH AVE N STE 2300
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2466
Mailing Address - Country:US
Mailing Address - Phone:979-704-6547
Mailing Address - Fax:
Practice Address - Street 1:577 GRANT ST STE B
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1535
Practice Address - Country:US
Practice Address - Phone:330-784-2162
Practice Address - Fax:770-441-3086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based