Healthcare Provider Details
I. General information
NPI: 1871258533
Provider Name (Legal Business Name): RENEWED ADVANCED HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/07/2021
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8523 COTTONWOOD DR APT 3
CINCINNATI OH
45231-5937
US
IV. Provider business mailing address
8523 COTTONWOOD DR APT 3
CINCINNATI OH
45231-5937
US
V. Phone/Fax
- Phone: 513-652-4558
- Fax:
- Phone: 513-652-4558
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FELICIA
R
SORRELLS
Title or Position: OWNER
Credential:
Phone: 513-652-4558