Healthcare Provider Details

I. General information

NPI: 1083863286
Provider Name (Legal Business Name): SAINT JOSEPH-ANC HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2464 FORTUNE DR SUITE 110
LEXINGTON KY
40509
US

IV. Provider business mailing address

6281 TRI RIDGE BLVD STE 300
LOVELAND OH
45140-8345
US

V. Phone/Fax

Practice location:
  • Phone: 859-277-5111
  • Fax:
Mailing address:
  • Phone: 513-576-0262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateKY

VIII. Authorized Official

Name: JACK HAWKINS
Title or Position: VP, FINANCE/CFO
Credential:
Phone: 513-576-8478