Healthcare Provider Details

I. General information

NPI: 1083117527
Provider Name (Legal Business Name): INTEGRITY HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6269 STOVER AVE
CINCINNATI OH
45237-4825
US

IV. Provider business mailing address

6269 STOVER AVE
CINCINNATI OH
45237-4825
US

V. Phone/Fax

Practice location:
  • Phone: 513-393-0912
  • Fax:
Mailing address:
  • Phone: 513-393-0912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateOH

VIII. Authorized Official

Name: LASHANDA R TATUM
Title or Position: OWNER
Credential: LPN
Phone: 513-393-0912