Provider Demographics
NPI:1215910021
Name:VISITING NURSE AND HOSPICE OF NE OHIO
Entity type:Organization
Organization Name:VISITING NURSE AND HOSPICE OF NE OHIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DOMINIC
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:330-884-2500
Mailing Address - Street 1:3530 BELMONT AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1400
Mailing Address - Country:US
Mailing Address - Phone:330-884-2500
Mailing Address - Fax:330-884-2550
Practice Address - Street 1:3530 BELMONT AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1400
Practice Address - Country:US
Practice Address - Phone:330-884-2500
Practice Address - Fax:330-884-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-25
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0073-HSP251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0546752Medicaid
OH0546752Medicaid