Provider Demographics
NPI:1821476268
Name:CEDAR KNOLL, LLC
Entity Type:Organization
Organization Name:CEDAR KNOLL, LLC
Other - Org Name:VILLAGE HOME HEALTH AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPNACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-782-2546
Mailing Address - Street 1:11275 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4113
Mailing Address - Country:US
Mailing Address - Phone:513-782-2546
Mailing Address - Fax:513-782-8306
Practice Address - Street 1:11275 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4113
Practice Address - Country:US
Practice Address - Phone:513-782-2546
Practice Address - Fax:513-782-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH369105Medicare PIN