Provider Demographics
NPI:1932919610
Name:SCAA SERVICE PROVIDERS INC
Entity type:Organization
Organization Name:SCAA SERVICE PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-709-1538
Mailing Address - Street 1:36311 DETROIT RD.,
Mailing Address - Street 2:STE. 205
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011
Mailing Address - Country:US
Mailing Address - Phone:440-709-1538
Mailing Address - Fax:
Practice Address - Street 1:36311 DETROIT RD.,
Practice Address - Street 2:STE. 205
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011
Practice Address - Country:US
Practice Address - Phone:440-709-1538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health