Healthcare Provider Details

I. General information

NPI: 1437533718
Provider Name (Legal Business Name): A TOUCH OF HEAVEN HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 OREGONIA RD
LEBANON OH
45036-9740
US

IV. Provider business mailing address

1061 OREGONIA RD
LEBANON OH
45036-9740
US

V. Phone/Fax

Practice location:
  • Phone: 904-834-1519
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KYONG NELSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 937-470-2174