Provider Demographics
NPI:1821538737
Name:HEALING SPRINGS MED- CARE LLC
Entity Type:Organization
Organization Name:HEALING SPRINGS MED- CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:UWAEZOUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-885-1060
Mailing Address - Street 1:1821 SUMMIT RD
Mailing Address - Street 2:200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-2822
Mailing Address - Country:US
Mailing Address - Phone:513-885-1060
Mailing Address - Fax:
Practice Address - Street 1:1821 SUMMIT RD
Practice Address - Street 2:200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-2822
Practice Address - Country:US
Practice Address - Phone:513-885-1060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36-9136Medicare PIN