| Organization Name: | COMPLETE CARE SUPPORTED LIVING SERVICE AGENCY |
| NPI Number: | 1669850228 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUANTE HALL (OWNER) |
| Mailing Address: | 8250 Winton Rd Ste 102 Cincinnati |
| State: | OH US |
| Postal Code: | 452315916 |
| Phone Number: | 5138732212 |
| Fax Number: | |
| NPI Enumeration Date: | 05/14/2015 |
| NPI Last Update Date: | 05/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |