Provider Demographics
NPI:1962935437
Name:SAMARITAN HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:SAMARITAN HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:THEISS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:440-561-7328
Mailing Address - Street 1:6151 WILSON MILLS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2128
Mailing Address - Country:US
Mailing Address - Phone:440-561-7328
Mailing Address - Fax:888-275-8526
Practice Address - Street 1:6151 WILSON MILLS RD STE 101
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-2128
Practice Address - Country:US
Practice Address - Phone:440-561-7328
Practice Address - Fax:888-275-8526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0207377Medicaid