Provider Demographics
NPI:1083117527
Name:INTEGRITY HOME HEALTH CARE
Entity type:Organization
Organization Name:INTEGRITY HOME HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHANDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:513-393-0912
Mailing Address - Street 1:6269 STOVER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-4825
Mailing Address - Country:US
Mailing Address - Phone:513-393-0912
Mailing Address - Fax:
Practice Address - Street 1:6269 STOVER AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-4825
Practice Address - Country:US
Practice Address - Phone:513-393-0912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRITY MEDICAL SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH320700000X, 374U00000X, 385H00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH12205683OtherINTEGRITY MEDICAL SOLUTIONS