Provider Demographics
NPI:1760231765
Name:EARLY CLOUD HOME CARE LLC
Entity type:Organization
Organization Name:EARLY CLOUD HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:WALLETTA
Authorized Official - Middle Name:TA
Authorized Official - Last Name:HOGANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-998-9027
Mailing Address - Street 1:600 UNION BLVD STE 206-B
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2121
Mailing Address - Country:US
Mailing Address - Phone:937-998-9027
Mailing Address - Fax:
Practice Address - Street 1:600 UNION BLVD STE 206-B
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2121
Practice Address - Country:US
Practice Address - Phone:937-998-9027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care