MEDICARE: CELEBRITRIESHEALTHCARESOLUTIONSLLC.

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	:	1881252914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CELEBRITRIESHEALTHCARESOLUTIONSLLC.

Provider Business Mailing Address
First Line	:	2113 HILLROSE CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-1419
Country	:	US
Telephone Number	:	513-375-5719
Fax Number	:	513-873-8885

Provider Business Practice Location Address
First Line	:	2648 STANTON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1619
Country	:	US
Telephone Number	:	513-375-5719
Fax Number	:	513-873-8885

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	MRS. DEBRA GREER
Credential	:	ADMINDTRATOR
Telephone Number	:	513-375-5719

Provider Enumeration Date	:	06/04/2019
Last Update Date	:	06/08/2019

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