1871897421 NPI number — INSPIRATION HOME CARE, LLC

Table of content: (NPI 1871897421)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871897421 NPI number — INSPIRATION HOME CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSPIRATION HOME CARE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KEEP HOPE ALIVE HOME CARE SERVICES, LLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871897421
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
235 FIRST ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43605-2041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-693-5645
Provider Business Mailing Address Fax Number:
419-255-5847

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43605-2041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-693-5645
Provider Business Practice Location Address Fax Number:
419-693-5645
Provider Enumeration Date:
12/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MCNEIL
Authorized Official First Name:
SHELIA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
419-693-5645

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1939198 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3066159 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2695641 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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