MEDICARE: TARGET HEALTH CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1023954369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TARGET HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	11497 SPRINGFIELD PIKE STE 7
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3551
Country	:	US
Telephone Number	:	513-426-8492
Fax Number	:	513-426-8641

Provider Business Practice Location Address
First Line	:	11497 SPRINGFIELD PIKE STE 7
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3551
Country	:	US
Telephone Number	:	513-426-8492
Fax Number	:	513-426-8641

Authorized Official
Title or Position	:	CEO
Name	:	MAMBWENE WAMBA
Credential	:
Telephone Number	:	513-426-8492

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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