Provider Demographics
NPI:1477983401
Name:SOUTHEAST OHIO HOME HERLP AGENCY, LLC
Entity Type:Organization
Organization Name:SOUTHEAST OHIO HOME HERLP AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-654-1000
Mailing Address - Street 1:225 S EWING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4038
Mailing Address - Country:US
Mailing Address - Phone:740-654-1000
Mailing Address - Fax:740-654-1009
Practice Address - Street 1:225 S EWING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4038
Practice Address - Country:US
Practice Address - Phone:740-654-1000
Practice Address - Fax:740-654-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health