Healthcare Provider Details

I. General information

NPI: 1831028851
Provider Name (Legal Business Name): BLOOMBRIDGE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MILLVALE CT
CINCINNATI OH
45225-1222
US

IV. Provider business mailing address

2000 MILLVALE CT
CINCINNATI OH
45225-1222
US

V. Phone/Fax

Practice location:
  • Phone: 513-220-0494
  • Fax:
Mailing address:
  • Phone: 513-220-0494
  • 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: TYLEEHA SHIRLEY ETTER-PARKER
Title or Position: OWNER
Credential:
Phone: 513-220-0494