Provider Demographics
NPI:1215146006
Name:ADVANCED CARE HOME HEALTH LTD.
Entity type:Organization
Organization Name:ADVANCED CARE HOME HEALTH LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUGABOOK
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:513-515-1554
Mailing Address - Street 1:11957 WINSTON CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1545
Mailing Address - Country:US
Mailing Address - Phone:513-771-1043
Mailing Address - Fax:513-771-1070
Practice Address - Street 1:260 NORTHLAND BLVD STE 225
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4920
Practice Address - Country:US
Practice Address - Phone:513-771-1043
Practice Address - Fax:513-771-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.309417251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health