MEDICARE: SHS CINCY, 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	3747P1801X	Personal Care Attendant
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1174135131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHS CINCY, LLC

Provider Business Mailing Address
First Line	:	3414 EDWARDS RD # 10
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2106
Country	:	US
Telephone Number	:	513-376-6497
Fax Number	:

Provider Business Practice Location Address
First Line	:	3414 EDWARDS RD # 10
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2106
Country	:	US
Telephone Number	:	513-376-6497
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINE M. HARRIS
Credential	:
Telephone Number	:	513-325-9667

Provider Enumeration Date	:	08/20/2020
Last Update Date	:	08/20/2020

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