=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447791082
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHAYAH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2017
-----------------------------------------------------
Last Update Date | 03/15/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1821 SUMMIT RD 300-Q
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45237-2822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-484-1915
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1821 SUMMIT RD 300-Q
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45237-2822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-484-1915
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. PAULA G FIELDS
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 513-484-1915
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 320954
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------