MEDICARE: DEPENDABLE DYNAMICS HOME CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1689375420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEPENDABLE DYNAMICS HOME CARE LLC

Provider Business Mailing Address
First Line	:	2517 AIRY CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-6559
Country	:	US
Telephone Number	:	704-277-7036
Fax Number	:

Provider Business Practice Location Address
First Line	:	2517 AIRY CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-6559
Country	:	US
Telephone Number	:	704-277-7036
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TINNIE J YOUNG
Credential	:
Telephone Number	:	704-277-7036

Provider Enumeration Date	:	03/16/2023
Last Update Date	:	03/20/2023

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