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General NPI Number Information
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NPI Number | 1093034340
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Entity Type | Organization
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Legal Business Name | STATE HEALTH CARE LTD
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 201 RIVERSIDE DR STE 2E
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City | DAYTON
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State | OH
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Zip | 45405-4956
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Country | US
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Telephone | 937-222-2537
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Fax | 937-222-2543
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Provider Business Mailing Address
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Address Line | 201 RIVERSIDE DR STE 2E
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City | DAYTON
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State | OH
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Zip | 45405-4956
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Country | US
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Telephone | 937-222-2537
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Fax | 937-222-2543
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Authorized Official
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Title or Position | CEO
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Name | MR. MOHAMED BARRE
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Credential |
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Telephone | 937-222-2537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 201013000811
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License Number State | OH
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