Organization
RESIDENTIAL COMMUNITY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO E. MITCHELL (PRESIDENT)
(513) 228-1489
Entity
Organization
Contact information
Practice address
409 N BROADWAY ST, LEBANON, OH 45036-1770
(513) 260-0602
Mailing address
409 N BROADWAY ST, LEBANON, OH 45036-1770
(513) 260-0602
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
159950
OH
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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