Healthcare Provider Details

I. General information

NPI: 1811600349
Provider Name (Legal Business Name): WILSON ESTATE HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 W GALBRAITH RD
CINCINNATI OH
45239-4848
US

IV. Provider business mailing address

1821 W GALBRAITH RD
CINCINNATI OH
45239-4848
US

V. Phone/Fax

Practice location:
  • Phone: 513-873-8808
  • Fax: 513-873-8507
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: SYMONE NICHOLE-MARIE WILSON
Title or Position: PRESIDENT
Credential:
Phone: 513-873-8808