MEDICARE: MT. HEALTHY CHRISTIAN HOME, INC.

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	310400000X	Assisted Living Facility	1287R	OH
2	314000000X	Skilled Nursing Facility	1287N	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245213826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MT. HEALTHY CHRISTIAN HOME, INC.

Provider Business Mailing Address
First Line	:	8097 HAMILTON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-2321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8097 HAMILTON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-2321
Country	:	US
Telephone Number	:	513-931-5000
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. BONNIE HAZELWOOD
Credential	:
Telephone Number	:	513-931-5000

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	09/11/2025

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