Healthcare Provider Details

I. General information

NPI: 1609149442
Provider Name (Legal Business Name): COMPLETE CARE PROVIDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 02/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9888 READING RD
CINCINNATI OH
45241-3104
US

IV. Provider business mailing address

9888 READING RD
CINCINNATI OH
45241-3104
US

V. Phone/Fax

Practice location:
  • Phone: 513-247-5056
  • Fax: 513-247-3467
Mailing address:
  • Phone: 513-247-5056
  • Fax: 513-247-3467

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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateOH

VIII. Authorized Official

Name: JAMES KITANGA
Title or Position: CEO
Credential:
Phone: 513-247-5056