MEDICARE: ALLY HOME HEALTHCARE, 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	:	1689902975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLY HOME HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	270 NORTHLAND BLVD
Second Line	:	SUITE 106
City	:	CINCINNATI
State	:	OH
Zip	:	45246-4911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	270 NORTHLAND BLVD
Second Line	:	SUITE 106
City	:	CINCINNATI
State	:	OH
Zip	:	45246-4911
Country	:	US
Telephone Number	:	513-226-7694
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	FAISAL ALI
Credential	:
Telephone Number	:	513-226-7694

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	11/24/2009

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