Organization
THE GOOD SHEPHERD HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MICHAEL WALLACE (CEO/VP OF BUSINESS DEVELOPMENT)
(513) 488-1938
Entity
Organization
Contact information
Practice address
11223 CORNELL PARK DR, SUITE 401, BLUE ASH, OH 45242-1835
(513) 488-1938
(513) 488-1934
Mailing address
11223 CORNELL PARK DR, SUITE 401, BLUE ASH, OH 45242-1835
(513) 488-1938
(513) 488-1934
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
3114427
OH
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3114427
—
OH
Enumeration date
09/28/2010
Last updated
03/17/2011
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