Healthcare Provider Details

I. General information

NPI: 1144545708
Provider Name (Legal Business Name): STAY WELL HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 EXECUTIVE PARK DR STE 225
CINCINNATI OH
45241-4009
US

IV. Provider business mailing address

4000 EXECUTIVE PARK DR STE 225
CINCINNATI OH
45241-4009
US

V. Phone/Fax

Practice location:
  • Phone: 513-297-4555
  • Fax: 513-297-4588
Mailing address:
  • Phone: 513-297-4555
  • Fax: 513-297-4588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY S MILLER
Title or Position: MANAGING MEMBER
Credential:
Phone: 513-605-2701