Provider Demographics
NPI:1912283722
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:A
Authorized Official - Last Name:UWAEZUOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-885-1060
Mailing Address - Street 1:1821 SUMMIT RD
Mailing Address - Street 2:STE 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:STE 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:2011-10-25
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 332B00000X
OH314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7416570001OtherPTAN