MEDICARE: SOLACE CARE STAFFING 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	251J00000X	Nursing Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1992422232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLACE CARE STAFFING LLC

Provider Business Mailing Address
First Line	:	2815 SPRINGDALE RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-1716
Country	:	US
Telephone Number	:	513-704-3281
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 ELM ST STE 2701399
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-2736
Country	:	US
Telephone Number	:	513-704-3281
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. TARA STARR WILSON
Credential	:	LPN
Telephone Number	:	513-704-3281

Provider Enumeration Date	:	10/27/2022
Last Update Date	:	11/01/2022

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