Healthcare Provider Details

I. General information

NPI: 1952803801
Provider Name (Legal Business Name): OUR UNIQUE ANGELS NURSING CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6240 HAMILTON AVE STE 6C
CINCINNATI OH
45224
US

IV. Provider business mailing address

3180 PRESERVE LN APT 3C
CINCINNATI OH
45239-6913
US

V. Phone/Fax

Practice location:
  • Phone: 513-327-8202
  • Fax:
Mailing address:
  • Phone: 513-706-9767
  • Fax: 513-706-9767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number160522
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number160522
License Number StateOH

VIII. Authorized Official

Name: MARKIANA CORNIST
Title or Position: OWNER/LPN
Credential: LPN
Phone: 513-706-9767