Provider Demographics
NPI:1073355228
Name:YOUN IVERSE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:YOUN IVERSE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-221-9982
Mailing Address - Street 1:522 PATTERSON CT
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75087-1039
Mailing Address - Country:US
Mailing Address - Phone:513-221-9982
Mailing Address - Fax:513-528-0126
Practice Address - Street 1:522 PATTERSON CT
Practice Address - Street 2:
Practice Address - City:FATE
Practice Address - State:TX
Practice Address - Zip Code:75087-1039
Practice Address - Country:US
Practice Address - Phone:513-221-9982
Practice Address - Fax:513-528-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health