Healthcare Provider Details

I. General information

NPI: 1689300014
Provider Name (Legal Business Name): FAMILY SERVICE CONNECT LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3335 NANDALE DR
CINCINNATI OH
45239-4013
US

IV. Provider business mailing address

3335 NANDALE DR
CINCINNATI OH
45239-4013
US

V. Phone/Fax

Practice location:
  • Phone: 513-356-1797
  • Fax:
Mailing address:
  • Phone: 513-356-1797
  • 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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DINA NATH BASTOLA
Title or Position: PRESIDENT
Credential:
Phone: 513-356-1797