Provider Demographics
NPI:1891587978
Name:SUPPORTIVE LIVING HOME HEALTH CARE
Entity type:Organization
Organization Name:SUPPORTIVE LIVING HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-631-1454
Mailing Address - Street 1:493 COMSTOCK ST NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-3209
Mailing Address - Country:US
Mailing Address - Phone:202-631-1454
Mailing Address - Fax:
Practice Address - Street 1:493 COMSTOCK ST NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-3209
Practice Address - Country:US
Practice Address - Phone:202-631-1454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health