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NPI 1174109391

NPI 1174109391 : OLIVER'S ASSISTED LIVING : CINCINNATI, OH

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General NPI Number Information
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    NPI Number           |    1174109391
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    Entity Type          |    Organization 
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    Legal Business Name  |    OLIVER'S ASSISTED LIVING 
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Dates
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    Enumeration Date     |    03/18/2021
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    Last Update Date     |    03/21/2021
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Provider Practice Location Address
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    Address Line         |    3413 WHEATCROFT DR 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45239-6151
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    Country              |    US
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    Telephone            |    513-968-7640
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3413 WHEATCROFT DR 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45239-6151
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    Country              |    US
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    Telephone            |    513-968-7640
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNERS
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    Name                 |     LAJUANNA R MADDOX 
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    Credential           |    
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    Telephone            |    513-968-7640
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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       |    
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    License Number State |    
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