Healthcare Provider Details
I. General information
NPI: 1982166567
Provider Name (Legal Business Name): 360 TOTAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2019
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 CHESTNUT ST
CINCINNATI OH
45203-1420
US
IV. Provider business mailing address
55 BECKLEY FARM WAY
SPRINGBORO OH
45066-7508
US
V. Phone/Fax
- Phone: 937-287-7472
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253J00000X |
| Taxonomy | Foster Care Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3104A0625X |
| Taxonomy | Assisted Living Facility (Mental Illness) |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332U00000X |
| Taxonomy | Home Delivered Meals |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2055X |
| Taxonomy | Child Mental Illness Respite Care |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2065X |
| Taxonomy | Child Physical Disabilities Respite Care |
| License Number | |
| License Number State | |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
JOINER
Title or Position: CEO
Credential:
Phone: 937-672-0971