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General NPI Number Information
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NPI Number | 1659638716
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Entity Type | Organization
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Legal Business Name | KATYS HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 47 S FAIRFIELD ST
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City | LEESBURG
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State | OH
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Zip | 45135-0335
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Country | US
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Telephone | 937-780-7977
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Fax |
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Provider Business Mailing Address
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Address Line | 12140 WILMINGTON AVE.
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City | HIGHLAND
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State | OH
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Zip | 45132
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Country | US
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Telephone | 937-763-3843
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KARI MARIE PHILLIPS
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Credential |
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Telephone | 937-763-1229
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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 | 2012390337
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License Number State | OH
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