MEDICARE: HOME CARE ASSISTANCE OF DAYTON

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	:	1639897580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME CARE ASSISTANCE OF DAYTON

Provider Business Mailing Address
First Line	:	6109 FAR HILLS AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-1925
Country	:	US
Telephone Number	:	937-353-7997
Fax Number	:

Provider Business Practice Location Address
First Line	:	6109 FAR HILLS AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-1925
Country	:	US
Telephone Number	:	937-353-7997
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KIRK L FEBUS
Credential	:
Telephone Number	:	937-353-7997

Provider Enumeration Date	:	08/17/2022
Last Update Date	:	08/17/2022

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