MEDICARE: CINCINNATI SNF HEALTHCARE 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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1932064961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATI SNF HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	3627 HARVEY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-2005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3627 HARVEY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-2005
Country	:	US
Telephone Number	:	513-961-8881
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JACOB STERN
Credential	:
Telephone Number	:	732-659-1353

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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