Provider Demographics
NPI:1285285676
Name:DEACONESS HOME HEALTH, LLC
Entity type:Organization
Organization Name:DEACONESS HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. FINANCE & CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-477-6305
Mailing Address - Street 1:6281 TRI RIDGE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8345
Mailing Address - Country:US
Mailing Address - Phone:513-576-0262
Mailing Address - Fax:
Practice Address - Street 1:6500 INTERCHANGE RD S STE A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8210
Practice Address - Country:US
Practice Address - Phone:812-425-3561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health