Provider Demographics
NPI:1972049963
Name:PIECES OF THE HEART GROUP HOME
Entity Type:Organization
Organization Name:PIECES OF THE HEART GROUP HOME
Other - Org Name:P & P BOARDINGHOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:K
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-306-6033
Mailing Address - Street 1:1302 LAIDLAW AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-5204
Mailing Address - Country:US
Mailing Address - Phone:513-306-6033
Mailing Address - Fax:
Practice Address - Street 1:1302 LAIDLAW AVE.
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237
Practice Address - Country:US
Practice Address - Phone:513-306-6033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0476704Medicaid
OH3125132OtherDODD