Provider Demographics
NPI:1982967725
Name:OLSON HOMECARE, LLC
Entity type:Organization
Organization Name:OLSON HOMECARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:S
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-988-3004
Mailing Address - Street 1:6145 PARK SQUARE DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-4146
Mailing Address - Country:US
Mailing Address - Phone:440-988-3004
Mailing Address - Fax:
Practice Address - Street 1:6145 PARK SQUARE DR
Practice Address - Street 2:SUITE 4
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-4146
Practice Address - Country:US
Practice Address - Phone:440-988-3004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care