Provider Demographics
NPI:1609149442
Name:COMPLETE CARE PROVIDERS, LLC
Entity Type:Organization
Organization Name:COMPLETE CARE PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KITANGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-247-5056
Mailing Address - Street 1:9888 READING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-3104
Mailing Address - Country:US
Mailing Address - Phone:513-247-5056
Mailing Address - Fax:513-247-3467
Practice Address - Street 1:9888 READING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-3104
Practice Address - Country:US
Practice Address - Phone:513-247-5056
Practice Address - Fax:513-247-3467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-09
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)