Provider Demographics
NPI:1053791640
Name:HEALTH TRENDS OF OHIO LLC
Entity type:Organization
Organization Name:HEALTH TRENDS OF OHIO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENEGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-803-0774
Mailing Address - Street 1:4368 DRESSLER RD NW
Mailing Address - Street 2:STE 201C
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2771
Mailing Address - Country:US
Mailing Address - Phone:330-493-0505
Mailing Address - Fax:
Practice Address - Street 1:4368 DRESSLER RD NW
Practice Address - Street 2:STE 201C
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2771
Practice Address - Country:US
Practice Address - Phone:330-493-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
36-9008Medicare PIN