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General NPI Number Information
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NPI Number | 1891118543
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Entity Type | Organization
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Legal Business Name | THE BALLEW CORPORATION LLC
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Dates
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Enumeration Date | 01/31/2014
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Last Update Date | 01/31/2014
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Provider Practice Location Address
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Address Line | 4504 LUCERNE AVE
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City | CINCINNATI
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State | OH
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Zip | 45227-2816
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Country | US
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Telephone | 513-258-9789
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Fax |
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Provider Business Mailing Address
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Address Line | 4504 LUCERNE AVE
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City | CINCINNATI
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State | OH
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Zip | 45227-2816
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Country | US
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Telephone | 513-258-9789
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JONATHAN L BALLEW
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Credential | M.ED
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Telephone | 513-375-4275
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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 | OH
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