Provider Demographics
NPI:1922867944
Name:PHOENIX A H HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:PHOENIX A H HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-787-7774
Mailing Address - Street 1:645 BLANCHE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-5405
Mailing Address - Country:US
Mailing Address - Phone:419-787-7774
Mailing Address - Fax:
Practice Address - Street 1:645 BLANCHE AVE FL 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-5405
Practice Address - Country:US
Practice Address - Phone:419-787-7774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty