Organization
FIRST ADVANTAGE HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA GALE PORTILLO (ADMINISTRATOR)
(513) 829-1278
Entity
Organization
Contact information
Practice address
1120 HICKS BLVD SUITE 100, FAIRFIELD, OH 45014
(513) 829-1278
(513) 829-1412
Mailing address
1120 HICKS BLVD STE 100, FAIRFIELD, OH 45014-9401
(513) 829-1278
(513) 829-1412
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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