MEDICARE: THE O'NEAL WELLNESS HOME 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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1437899374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE O'NEAL WELLNESS HOME LLC

Provider Business Mailing Address
First Line	:	4439 READING RD STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-1256
Country	:	US
Telephone Number	:	513-371-8041
Fax Number	:

Provider Business Practice Location Address
First Line	:	4439 READING RD STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-1256
Country	:	US
Telephone Number	:	513-371-8041
Fax Number	:	513-586-0434

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CHENIEA DONNISE O'NEAL
Credential	:
Telephone Number	:	513-371-8041

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	03/30/2022

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