Provider Demographics
NPI:1811458110
Name:QUEEN CITY HOME HEALTH CARE INC
Entity type:Organization
Organization Name:QUEEN CITY HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAROSHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-289-9673
Mailing Address - Street 1:10901 REED HARTMAN HWY STE 106
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10901 REED HARTMAN HWY STE 106
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2847
Practice Address - Country:US
Practice Address - Phone:513-745-0383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0337314Medicaid