MEDICARE: EBONY BIG HEART CARE HOMES

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1952270159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EBONY BIG HEART CARE HOMES

Provider Business Mailing Address
First Line	:	311 ELM ST STE 2701960
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-2736
Country	:	US
Telephone Number	:	513-796-5314
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 ELM ST STE 2701960
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-2736
Country	:	US
Telephone Number	:	513-796-5314
Fax Number	:

Authorized Official
Title or Position	:	STNA
Name	:	EBONY WADE
Credential	:
Telephone Number	:	513-780-3980

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	11/04/2025

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