Provider Demographics
NPI:1902350002
Name:INSTITUTE OF HEALTH TECHNOLOGY, LLC
Entity Type:Organization
Organization Name:INSTITUTE OF HEALTH TECHNOLOGY, LLC
Other - Org Name:ICON HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRITNEY
Authorized Official - Middle Name:T
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:216-903-6615
Mailing Address - Street 1:3715 WARRENSVILLE CENTER RD
Mailing Address - Street 2:#426
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6330
Mailing Address - Country:US
Mailing Address - Phone:216-903-6615
Mailing Address - Fax:
Practice Address - Street 1:3715 WARRENSVILLE CENTER RD
Practice Address - Street 2:#426
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6330
Practice Address - Country:US
Practice Address - Phone:216-903-6615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care