Provider Demographics
NPI:1376082784
Name:COMMUNITY HOME CARE LLC
Entity Type:Organization
Organization Name:COMMUNITY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TITKINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-583-0979
Mailing Address - Street 1:10979 REED HARTMAN HWY STE 331G
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2825
Mailing Address - Country:US
Mailing Address - Phone:513-853-0978
Mailing Address - Fax:
Practice Address - Street 1:10979 REED HARTMAN HWY STE 331G
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2825
Practice Address - Country:US
Practice Address - Phone:513-853-0978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2245809251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health