Healthcare Provider Details

I. General information

NPI: 1417202516
Provider Name (Legal Business Name): CINCICARES HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 09/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8050 BECKETT CENTER DR SUITE 325
WEST CHESTER OH
45069-5017
US

IV. Provider business mailing address

8050 BECKETT CENTER DR SUITE 325
WEST CHESTER OH
45069-5017
US

V. Phone/Fax

Practice location:
  • Phone: 513-389-7634
  • Fax: 513-389-7633
Mailing address:
  • Phone: 513-389-7634
  • Fax: 513-389-7633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2120057
License Number StateOH

VIII. Authorized Official

Name: MR. JOSEPH GERALD WAKLATSI
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 513-389-7634