MEDICARE: ANELE HEALTH CARE SERVICES 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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1548009780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANELE HEALTH CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1561 RUTH AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45207-1417
Country	:	US
Telephone Number	:	513-223-1845
Fax Number	:

Provider Business Practice Location Address
First Line	:	1561 RUTH AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45207-1417
Country	:	US
Telephone Number	:	513-223-1845
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DR. KERA LYNN LONGMIRE
Credential	:	EDD
Telephone Number	:	513-223-1845

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	09/17/2024

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Directions to “ANELE HEALTH CARE SERVICES LLC ” Practice Location

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