Provider Demographics
NPI:1467773473
Name:MONTGOMERY HOME CARE INITIATIVES, LLC
Entity Type:Organization
Organization Name:MONTGOMERY HOME CARE INITIATIVES, LLC
Other - Org Name:MONTGOMERY HOME CARE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-702-4290
Mailing Address - Street 1:5761 SPRINGDALE RD
Mailing Address - Street 2:SUITE O
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-2727
Mailing Address - Country:US
Mailing Address - Phone:513-702-4290
Mailing Address - Fax:
Practice Address - Street 1:5761 SPRINGDALE RD
Practice Address - Street 2:SUITE O
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-2727
Practice Address - Country:US
Practice Address - Phone:513-702-4290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health