MEDICARE: GIFTEDSOULS513 INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	164W00000X	Licensed Practical Nurse
2	251S00000X	Community/Behavioral Health Agency
3	253Z00000X	In Home Supportive Care Agency
4	261QM0850X	Adult Mental Health Clinic/Center
5	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
6	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1235098765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFTEDSOULS513 INC

Provider Business Mailing Address
First Line	:	3190 MCHENRY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-7343
Country	:	US
Telephone Number	:	513-740-4438
Fax Number	:

Provider Business Practice Location Address
First Line	:	3190 MCHENRY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-7343
Country	:	US
Telephone Number	:	513-740-4438
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MIRANDA MAE MUSE
Credential	:	STNA
Telephone Number	:	513-740-4438

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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