Organization Active NPI

Legacy Home Health Services LLC

  • Home Health Agency
  • Cleveland Heights, OH
National Provider Identifier
1598216046
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LEGACY HOME HEALTH SERVICES LLC
Practice address
2490 Lee Blvd Ste 311
Cleveland Heights, OH 44118-1404
Phone
(216) 446-2929
NPI assigned
Oct 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ahmed A Abdullahi
Title
Ceo
Phone
(216) 446-2929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X OH Primary

Addresses

Primary practice location

2490 Lee Blvd Ste 311
Cleveland Heights, OH 44118-1404

Mailing address

2490 Lee Blvd Ste 311
Cleveland Heights, OH 44118-1404
Phone (216) 446-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170520000187 OH Part A Provider - Home Health Agency 7012284128 Practice locations: Cleveland Heights, OH

Home health agency certification: CCN 369185

Legal name
LEGACY HOME HEALTH SERVICES LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 8, 2018
Last certification
Apr 8, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jul 20, 2016 in OH
Enrollment address
2490 Lee Blvd
Ste 311
Cleveland Heights, OH 44118-1404

Care Compare: Home health agency

Medicare Care Compare
Listed as
Legacy Home Health Services LLCCCN 369185 · All quality measures
Ownership
Proprietary
Certified
Apr 8, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide

National Provider Directory

National Provider Directory

Locations

680 E Market St
Ste 300
Akron, OH 44304
Phone (330) 299-4940

2490 Lee Blvd
Ste 311
Cleveland Heights, OH 44118
Phone (216) 233-0590

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ahmed Abdullahi Individual 5% Or Greater Direct Ownership Interest Jul 20, 2016 100%
5% Or Greater Security Interest Jul 20, 2016 100%
Corporate OfficerCeo Jul 20, 2016 100%
Corporate DirectorPresident Board of Dirs Jul 20, 2016
W-2 Managing EmployeeCeo Jul 20, 2016 100%

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1598216046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD STE 311",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181404",
            "telephone_number": "216-446-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD STE 311",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181404",
            "telephone_number": "216-446-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HOME HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "ABDULLAHI",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-446-2929"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland Heights, OH

Sources for this page

Verify at the official NPI Registry.