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General NPI Number Information
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NPI Number | 1265783278
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Entity Type | Organization
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Legal Business Name | TARGET HEALTH CARE LLC
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 11497 SPRINGFIELD PIKE STE 7
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City | SPRINGDALE
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State | OH
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Zip | 45246-3551
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Country | US
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Telephone | 513-426-8492
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Fax | 513-426-8641
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Provider Business Mailing Address
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Address Line | 11497 SPRINGFIELD PIKE STE 7
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City | SPRINGDALE
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State | OH
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Zip | 45246-3551
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Country | US
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Telephone | 513-609-8524
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Fax | 513-426-8641
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MRS. SYLVIE MUKANSE WAMBA
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Credential |
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Telephone | 513-609-8524
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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 | 201226801156
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License Number State | OH
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