Healthcare Provider Details

I. General information

NPI: 1265011795
Provider Name (Legal Business Name): HEALTHY ADULT DAY HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 BURLINGTON PIKE
FLORENCE KY
41042-4908
US

IV. Provider business mailing address

3418 FEBRUARY DR
CINCINNATI OH
45239-5439
US

V. Phone/Fax

Practice location:
  • Phone: 513-765-0768
  • Fax:
Mailing address:
  • Phone: 151-376-5076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEE KUIKEL
Title or Position: OWNER
Credential:
Phone: 513-765-0768