Provider Demographics
NPI:1962919704
Name:INTEGRITY HOME CARE OF OHIO
Entity type:Organization
Organization Name:INTEGRITY HOME CARE OF OHIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEROY
Authorized Official - Middle Name:TERRANCE
Authorized Official - Last Name:GREENIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-238-0456
Mailing Address - Street 1:926 W FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-2806
Mailing Address - Country:US
Mailing Address - Phone:937-938-7019
Mailing Address - Fax:937-637-2004
Practice Address - Street 1:926 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-2806
Practice Address - Country:US
Practice Address - Phone:937-938-7019
Practice Address - Fax:937-637-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========Medicaid