Toledo Home Health Services LLC
Organization Active NPI Home Health Agency · Toledo, OH
NPI 1275959223 · NPPES record last updated Apr 16, 2024
Key facts
- NPI
- 1275959223
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- TOLEDO HOME HEALTH SERVICES LLC
- Practice address
- 5810 Southwyck Blvd Ste 203C
Toledo, OH 43614-1545 - Phone
- (419) 214-1111
- NPI assigned
- Mar 14, 2014
- Organization subpart
- No
Authorized official
- Name
- Mohamed Ibrahim
- Title
- Owner
- Phone
- (419) 214-1111
Medicare Care Compare: Home health agency
- Listed as
- Toledo Home Health Services LLC
- Ownership
- Proprietary
- Certified
- Apr 6, 2016
- Medicare certification status
- Active
- Services
- Nursing, Home health aide
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2087265 | Toledo Home Health Services, LLC | Certificate of waiver | Nov 19, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Home health agency certification: CCN 369134
- Legal name
- TOLEDO HOME HEALTH SERVICES LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 6, 2016
- Last certification
- Dec 17, 2018
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Mar 3, 2014 in OH
- Enrollment address
- 5810 Southwyck Blvd
Ste 203C
Toledo, OH 43614-1545
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Mohamed Ibrahim |
5% Or Greater Direct Ownership Interest | Apr 18, 2019 | 100% |
| W-2 Managing Employee |
Jul 6, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140613002212 | OH | Part a Provider - Home Health Agency | 4183848120 | Practice locations: Toledo, OH |
National Provider Directory
Locations
5810 Southwyck Blvd
Ste 203C
Toledo, OH 43614
Phone (419) 214-1111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
5810 Southwyck Blvd Ste 203C
Toledo, OH 43614-1545
Mailing address
5810 Southwyck Blvd Ste 203C
Toledo, OH 43614-1545
Phone (419) 214-1111
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.