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General NPI Number Information
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NPI Number | 1740503010
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Entity Type | Organization
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Legal Business Name | SENIOR CARE OHIO, LLC
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 7588 CENTRAL PARKE BLVD SUITE 322
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City | MASON
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State | OH
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Zip | 45040-6857
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Country | US
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Telephone | 513-204-7921
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Fax | 513-229-0063
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Provider Business Mailing Address
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Address Line | 7588 CENTRAL PARKE BLVD SUITE 322
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City | MASON
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State | OH
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Zip | 45040-6857
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Country | US
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Telephone | 513-204-7921
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Fax | 513-229-0063
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GUYER R MCCRACKEN
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Credential |
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Telephone | 513-204-7921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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