MEDICARE: CHILDREN'S HOME CARE OF DAYTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000002747	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477722031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S HOME CARE OF DAYTON

Provider Business Mailing Address
First Line	:	18 CHILDRENS PLZ
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45404-1816
Country	:	US
Telephone Number	:	937-641-4663
Fax Number	:	937-641-5339

Provider Business Practice Location Address
First Line	:	18 CHILDRENS PLZ
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45404-1816
Country	:	US
Telephone Number	:	937-641-4663
Fax Number	:	937-641-5339

Authorized Official
Title or Position	:	C.F.O.
Name	:	MR. CHRIS BERGMAN
Credential	:	CFO
Telephone Number	:	937-641-3338

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	04/29/2020

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Directions to “CHILDREN'S HOME CARE OF DAYTON ” Practice Location

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