Healthcare Provider Details

I. General information

NPI: 1134472178
Provider Name (Legal Business Name): PEOPLE'S CHOICE RESIDENTIAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

872 HOLYOKE DR
CINCINNATI OH
45240-1839
US

IV. Provider business mailing address

872 HOLYOKE DR
CINCINNATI OH
45240-1839
US

V. Phone/Fax

Practice location:
  • Phone: 513-377-6417
  • Fax:
Mailing address:
  • Phone: 513-377-6417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2136348
License Number StateOH

VIII. Authorized Official

Name: TIYETTA JOINER
Title or Position: DIRECTOR
Credential:
Phone: 513-377-6417