Organization
PHASE 1 HOME CARE SERVICES
Active
Other names
Phase 1 Home care services
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWANNA F LASLEY (OWNER)
(513) 364-4606
Entity
Organization
Contact information
Practice address
1909 TRUITT AVE APT 1, CINCINNATI, OH 45212-1041
(513) 364-4606
Mailing address
1909 TRUITT AVE APT 1, CINCINNATI, OH 45212-1041
(513) 364-4606
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0485634
—
OH
Enumeration date
11/11/2022
Last updated
11/14/2022
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