Active NPI
Legacy Home Health Services LLC
- Home Health Agency
- Cleveland Heights, OH
National Provider Identifier
1598216046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 LLC
- Ownership
- Proprietary
- Certified
- Apr 8, 2018
- Medicare certification status
- Active
- Services
- Nursing, Home health aide
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Ahmed Abdullahi | 5% Or Greater Direct Ownership Interest | Jul 20, 2016 | 100% |
| 5% Or Greater Security Interest | Jul 20, 2016 | 100% | |
| Corporate Officer | Jul 20, 2016 | 100% | |
| Corporate Director | Jul 20, 2016 | ||
| W-2 Managing Employee | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.