MEDICARE: COACH COMPASSIONATE CARE LLC

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

General Provider Information

NPI Number	:	1619824414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COACH COMPASSIONATE CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 14134
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45250-0134
Country	:	US
Telephone Number	:	513-418-1825
Fax Number	:

Provider Business Practice Location Address
First Line	:	4249 ILIUM AVE APT 1402
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-0008
Country	:	US
Telephone Number	:	513-418-1825
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BREASIA MONICA BRICE
Credential	:	RN
Telephone Number	:	513-418-1825

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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