Provider Demographics
NPI:1225809577
Name:EXECUTIVE LONGTERM CARE CONSULTING
Entity Type:Organization
Organization Name:EXECUTIVE LONGTERM CARE CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GERIATRIC CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DUNISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:513-802-8573
Mailing Address - Street 1:2880 GROSVENOR DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2880 GROSVENOR DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1707
Practice Address - Country:US
Practice Address - Phone:513-802-8573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care