Provider Demographics
NPI:1114312253
Name:ANTOINETTA NURSING SERVICE LLC
Entity Type:Organization
Organization Name:ANTOINETTA NURSING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-326-5429
Mailing Address - Street 1:2300 MONTANA AVE SUITE 200-B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:95211
Mailing Address - Country:US
Mailing Address - Phone:513-326-5429
Mailing Address - Fax:513-772-0340
Practice Address - Street 1:2300 MONTANA AVE SUITE 200-B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:95211
Practice Address - Country:US
Practice Address - Phone:513-326-5429
Practice Address - Fax:513-772-0340
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTOINETTA NURSING SERVICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty