=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801481437
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MASLOW HOMEHEALTH AGENCY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2021
-----------------------------------------------------
Last Update Date | 03/05/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11497 SPRINGFIELD PIKE STE 3-4
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45246-3551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-390-4274
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11497 SPRINGFIELD PIKE STE 3-4
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45246-3551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-390-4274
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT & CEO
-----------------------------------------------------
Name | BEN-COLLINS O UWAEZUOKE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 513-257-8485
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------