Healthcare Provider Details

I. General information

NPI: 1811514953
Provider Name (Legal Business Name): ONE FAMILY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2020
Last Update Date: 07/05/2020
Certification Date: 07/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8044 MONTGOMERY RD STE 700
CINCINNATI OH
45236-2926
US

IV. Provider business mailing address

8044 MONTGOMERY RD STE 700
CINCINNATI OH
45236-2926
US

V. Phone/Fax

Practice location:
  • Phone: 513-792-2703
  • Fax:
Mailing address:
  • Phone: 513-792-2703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. DEANIKKA MONEE ANDREWSS
Title or Position: OWNER/CEO
Credential:
Phone: 513-792-2703