Organization
COMPLETE CARE SUPPORTED LIVING SERVICE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUANTE HALL (OWNER)
(513) 873-2212
Entity
Organization
Contact information
Practice address
8250 WINTON RD STE 102, CINCINNATI, OH 45231-5916
(513) 873-2212
Mailing address
8250 WINTON RD STE 102, CINCINNATI, OH 45231-5916
(513) 873-2212
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0104122
—
OH
Enumeration date
05/14/2015
Last updated
05/14/2015
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