Provider Demographics
NPI:1891107884
Name:DONTY HORTON HOME CARE (DHHC) LLC
Entity Type:Organization
Organization Name:DONTY HORTON HOME CARE (DHHC) LLC
Other - Org Name:DESTINATION TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONTY
Authorized Official - Middle Name:FELIPE
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-791-0200
Mailing Address - Street 1:2692 MADISON RD STE N1-192
Mailing Address - Street 2:SUITE N1-192
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1321
Mailing Address - Country:US
Mailing Address - Phone:513-283-0079
Mailing Address - Fax:513-283-0078
Practice Address - Street 1:10901 REED HARTMAN HWY
Practice Address - Street 2:SUITE 112
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2831
Practice Address - Country:US
Practice Address - Phone:513-283-0079
Practice Address - Fax:513-283-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2014-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2925106251C00000X, 253Z00000X, 343900000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2925106Medicaid