MEDICARE: RESCUE91 HEALTHCARE SERVICES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1598575144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESCUE91 HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	1715 SPRINGFIELD ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1431
Country	:	US
Telephone Number	:	937-500-5371
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 SPRINGFIELD ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1431
Country	:	US
Telephone Number	:	937-500-5371
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KELVIN AFFUL
Credential	:
Telephone Number	:	937-500-5371

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	01/24/2025

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