MEDICARE: MICHAELS ANGELS HOME HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	163W00000X	Registered Nurse
2	174200000X	Meals Provider
3	251B00000X	Case Management Agency
4	251C00000X	Developmentally Disabled Services Day Training Agency
5	343900000X	Non-emergency Medical Transport (VAN)
6	3747P1801X	Personal Care Attendant
7	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
8	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356928022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAELS ANGELS HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	9460 HADDINGTON CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-5131
Country	:	US
Telephone Number	:	513-885-9625
Fax Number	:

Provider Business Practice Location Address
First Line	:	9460 HADDINGTON CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-5131
Country	:	US
Telephone Number	:	513-885-9625
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	MRS. ALEXIA M ALY
Credential	:	MHA
Telephone Number	:	513-885-9625

Provider Enumeration Date	:	03/26/2021
Last Update Date	:	03/11/2022

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