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General NPI Number Information
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NPI Number | 1720404197
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Entity Type | Organization
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Legal Business Name | IN LIVING SUPPORT
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Dates
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Enumeration Date | 03/10/2014
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 230 NORTHLAND BLVD STE 135
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City | CINCINNATI
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State | OH
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Zip | 45246-3691
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Country | US
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Telephone | 513-376-8473
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Fax |
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Provider Business Mailing Address
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Address Line | 230 NORTHLAND BLVD STE 135
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City | CINCINNATI
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State | OH
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Zip | 45246-3691
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Country | US
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Telephone | 513-376-8473
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SEDRA LLEWELLYN TAYLOR
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Credential |
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Telephone | 513-376-8473
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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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