Provider Demographics
NPI:1518530575
Name:NATTINGHAM LLC DBA NATTINGHAM HOME CARE
Entity Type:Organization
Organization Name:NATTINGHAM LLC DBA NATTINGHAM HOME CARE
Other - Org Name:NATTINGHAM HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-509-0604
Mailing Address - Street 1:260 NORTHLAND BLVD STE 127A
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4908
Mailing Address - Country:US
Mailing Address - Phone:513-509-0604
Mailing Address - Fax:513-672-1044
Practice Address - Street 1:260 NORTHLAND BLVD STE 127A
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-4908
Practice Address - Country:US
Practice Address - Phone:513-509-0604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0479037Medicaid