NON-AGENCY PROVIDER NPI 1790193142

NPI Information

  • NPI: 1790193142
  • Provider Name: NON-AGENCY PROVIDER
  • Classification: In Home Supportive Care - 253Z00000X
  • Entity Type: Organization
  • Address: 225 EDNA AVE
    FAIRBORN, OH
    ZIP 45324
  • Phone: (937) 878-6886

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NPI Details

NON-AGENCY PROVIDER is an in home supportive care in Fairborn, OH. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. NON-AGENCY PROVIDER NPI is 1790193142. The provider is registered as an organization entity type.

The provider's business location address is:

225 EDNA AVE
FAIRBORN, OH
ZIP 45324-354
Phone: (937) 878-6886

The provider's authorized official is Cynthia S Quinn .
The authorized official title is Personal Care Aide and has the following contact phone number (937) 878-6886.

The enumeration date for this NPI number is 7/29/2014 and was last updated on 7/29/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1253Z00000XIn Home Supportive Care400960020809OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10071052OTHEROHIOMEDICAID WAIVER PROGRAM
20071052MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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