MEDICARE: KENWOOD TERRACE HEALTH CARE CENTER, INC.

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	314000000X	Skilled Nursing Facility	6337	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790774578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENWOOD TERRACE HEALTH CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	7450 KELLER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45243-1028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7450 KELLER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45243-1028
Country	:	US
Telephone Number	:	513-793-2255
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAROLD SOSNA
Credential	:
Telephone Number	:	513-561-4105

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	08/14/2020

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