MEDICARE: INTERNATIONAL HEALTH, 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1992698575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNATIONAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	6371 NEWGRANGE DR
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-8618
Country	:	US
Telephone Number	:	614-981-9594
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 W 2ND ST STE 200
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-1873
Country	:	US
Telephone Number	:	614-981-9594
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. DON BASHAW
Credential	:
Telephone Number	:	614-981-9594

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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