Provider Demographics
NPI:1679842124
Name:PEARLS ULITMATE HOMECARE SERVICE LLC
Entity Type:Organization
Organization Name:PEARLS ULITMATE HOMECARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:BELL
Authorized Official - Last Name:BARNFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-602-8565
Mailing Address - Street 1:4345 DANE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1172 W GALBRAITH RD
Practice Address - Street 2:205B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5647
Practice Address - Country:US
Practice Address - Phone:513-541-0384
Practice Address - Fax:513-541-0724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253J00000X
OH3113688253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3033621Medicaid
OH3113688OtherDODD CONTRACT NUMBER