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General NPI Number Information
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NPI Number | 1851628028
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN HOME CARE LLC
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Dates
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Enumeration Date | 11/10/2009
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 1225 WOODLAWN AVE STE 113
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City | CAMBRIDGE
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State | OH
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Zip | 43725-3094
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Country | US
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Telephone | 740-425-5117
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Fax | 740-425-5062
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Provider Business Mailing Address
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Address Line | 6281 TRI RIDGE BLVD STE 300
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City | LOVELAND
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State | OH
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Zip | 45140-8345
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Country | US
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Telephone | 513-576-0262
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Fax |
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Authorized Official
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Title or Position | VP FINANCE, CFO
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Name | JACK HAWKINS
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Credential |
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Telephone | 513-576-8478
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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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