Healthcare Provider Details

I. General information

NPI: 1316737497
Provider Name (Legal Business Name): MOUNT MARY HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 W KEMPER RD APT 414
CINCINNATI OH
45240-1671
US

IV. Provider business mailing address

1440 W KEMPER RD APT 414
CINCINNATI OH
45240-1671
US

V. Phone/Fax

Practice location:
  • Phone: 513-499-6734
  • Fax:
Mailing address:
  • Phone: 513-499-6734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ADELINE ABENG KEMEH
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 513-499-6734