Jeffrey Glaze

Individual provider Active NPI In Home Supportive Care Agency · Aurora, OH

NPI 1861075657 · NPPES record last updated Apr 30, 2021

Key facts

NPI
1861075657
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Practice address
1139 E Garfield Rd
Aurora, OH 44202-7755
Phone
(440) 382-2399
NPI assigned
Apr 30, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X
Private Vehicle 347C00000X
Homemaker 376J00000X
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

1139 E Garfield Rd
Aurora, OH 44202-7755

Mailing address

1139 E Garfield Rd
Aurora, OH 44202-7755
Phone (440) 382-2399

Other identifiers

IdentifierTypeStateIssuer
0430148MedicaidOH

Other providers in Aurora, OH

All providers in Aurora, OH · In Home Supportive Care Agency in Ohio

Sources for this page

Verify at the official NPI Registry.