Provider Demographics
NPI:1326630054
Name:INVITO PERSONAL CHEF
Entity Type:Organization
Organization Name:INVITO PERSONAL CHEF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:PERSONAL CHEF
Authorized Official - Phone:513-746-8233
Mailing Address - Street 1:4657 KIRBY AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1521
Mailing Address - Country:US
Mailing Address - Phone:513-746-8233
Mailing Address - Fax:
Practice Address - Street 1:4222 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-2095
Practice Address - Country:US
Practice Address - Phone:513-746-8233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INVITO PERSONAL CHEF
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1457940819Medicaid