MEDICARE: JEANNE M CARDINALE SHARED LIVING

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	253Z00000X	In Home Supportive Care Agency	2545320	OH

General Provider Information

NPI Number	:	1750207452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE M CARDINALE SHARED LIVING

Provider Business Mailing Address
First Line	:	6852 ROUNDELAY RD N
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-1733
Country	:	US
Telephone Number	:	614-256-2133
Fax Number	:

Provider Business Practice Location Address
First Line	:	6852 ROUNDELAY RD N
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-1733
Country	:	US
Telephone Number	:	614-256-2133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2026
Last Update Date	:	06/26/2026

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