Healthcare Provider Details

I. General information

NPI: 1316647969
Provider Name (Legal Business Name): ARDENT RESIDENTIAL CARE CONCIERGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E BUSINESS WAY STE 200
CINCINNATI OH
45241-2389
US

IV. Provider business mailing address

300 E BUSINESS WAY STE 200
CINCINNATI OH
45241-2389
US

V. Phone/Fax

Practice location:
  • Phone: 513-247-6100
  • Fax:
Mailing address:
  • Phone: 513-247-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: TYESHIA LASHAE SMITH
Title or Position: CEO
Credential:
Phone: 513-602-4639