Healthcare Provider Details

I. General information

NPI: 1063645588
Provider Name (Legal Business Name): TUTTLE HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 SYLVAN SHORES DR
SOUTH VIENNA OH
45369-8521
US

IV. Provider business mailing address

69 SYLVAN SHORES DR
SOUTH VIENNA OH
45369-8521
US

V. Phone/Fax

Practice location:
  • Phone: 937-408-2682
  • Fax:
Mailing address:
  • Phone: 937-408-2682
  • 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: MR. CASEY YOUNG
Title or Position: OWNER
Credential: PA
Phone: 937-408-2682