Healthcare Provider Details

I. General information

NPI: 1285562876
Provider Name (Legal Business Name): FRUIT OF THE SPIRIT HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3446 BROOKLINE AVE
CINCINNATI OH
45220-1846
US

IV. Provider business mailing address

3446 BROOKLINE AVE
CINCINNATI OH
45220-1846
US

V. Phone/Fax

Practice location:
  • Phone: 317-600-7126
  • Fax:
Mailing address:
  • Phone: 317-600-7126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JONNETTE EDWARDS
Title or Position: CEO/PROVIDER
Credential:
Phone: 317-459-2363