Non-Agency Provider

NPI #1790193142 in Fairborn, Ohio

Provider Information

NPI Number: 1790193142
Entity Type: Organization
Organization Name: Non-Agency Provider
Primary Specialty: In Home Supportive Care
Enumeration Date: Jul 29, 2014
Last Updated: Jul 29, 2014

Practice Location

Address: 225 EDNA AVE
City: Fairborn
State: Ohio
ZIP Code: 45324-2354
Phone: (937) 878-6886

Authorized Official

Name: MS. CYNTHIA S QUINN
Title: PERSONAL CARE AIDE
Phone: (937) 878-6886

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
In Home Supportive Care	253Z00000X	Primary

Similar Providers

Individual Providers

Provider Name	Specialty	City
MRS. Coleen Phillips Casillano	In Home Supportive Care	Fairborn	AI Deep Dive
MS. Regina A Shearer	In Home Supportive Care	Fairborn	AI Deep Dive
Aline Gladis Ngandu	In Home Supportive Care	Fairborn	AI Deep Dive
John Christian Schlegel Marretta	In Home Supportive Care	Fairborn	AI Deep Dive

Organizations

Provider Name	Specialty	City
Masonic Senior Services of Ohio Corp. Part of The Ohio Masonic Home	In Home Supportive Care	Fairborn	AI Deep Dive

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