MEDICARE: GLINECOS RESIDENTIAL HOME CARE

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1215522891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLINECOS RESIDENTIAL HOME CARE

Provider Business Mailing Address
First Line	:	4873 KLEEMAN GREEN DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1991
Country	:	US
Telephone Number	:	513-379-4434
Fax Number	:

Provider Business Practice Location Address
First Line	:	4873 KLEEMAN GREEN DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1991
Country	:	US
Telephone Number	:	513-379-4434
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. MARY GLINES
Credential	:
Telephone Number	:	513-379-4434

Provider Enumeration Date	:	03/04/2021
Last Update Date	:	03/04/2021

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