Provider Demographics
NPI:1568532422
Name:ALTERNATIVE HOME CARE AND STAFFING
Entity Type:Organization
Organization Name:ALTERNATIVE HOME CARE AND STAFFING
Other - Org Name:ACHIEVE REHAB & HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WICKLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-794-0555
Mailing Address - Street 1:5150 EAST GALBRAITH ROAD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2871
Mailing Address - Country:US
Mailing Address - Phone:513-794-0555
Mailing Address - Fax:513-794-1539
Practice Address - Street 1:5150 EAST GALBRAITH ROAD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2871
Practice Address - Country:US
Practice Address - Phone:513-794-0555
Practice Address - Fax:513-794-1539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2007992Medicaid
OH2007992Medicaid