Provider Demographics
NPI:1093103657
Name:FIRSTLIGHT HOMECARE LLC
Entity Type:Organization
Organization Name:FIRSTLIGHT HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATIONAL ALLIANCE COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARNED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-766-8402
Mailing Address - Street 1:7870 E KEMPER RD STE 440
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-1675
Mailing Address - Country:US
Mailing Address - Phone:513-766-8402
Mailing Address - Fax:513-830-5003
Practice Address - Street 1:9435 WATERSTONE BLVD
Practice Address - Street 2:190
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-8226
Practice Address - Country:US
Practice Address - Phone:513-766-8402
Practice Address - Fax:513-830-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care