Organization
NON-AGENCY PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA S QUINN (PERSONAL CARE AIDE)
(937) 878-6886
Entity
Organization
Contact information
Practice address
225 EDNA AVE, FAIRBORN, OH 45324-2354
(937) 878-6886
Mailing address
225 EDNA AVE, FAIRBORN, OH 45324-2354
(937) 878-6886
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
400960020809
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0071052
MEDICAID WAIVER PROGRAM
OH
05
—
0071052
—
OH
Enumeration date
07/29/2014
Last updated
07/29/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us