Irvin Cruz

Individual provider Active NPI Personal Care Attendant · Maineville, OH

NPI 1104589779 · NPPES record last updated Oct 20, 2021

Key facts

NPI
1104589779
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
487 Willow Pond Blvd Apt 104
Maineville, OH 45039-7092
Phone
(513) 537-0433
NPI assigned
Oct 20, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X
Non-emergency Medical Transport (VAN) 343900000X
Homemaker 376J00000X
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

487 Willow Pond Blvd Apt 104
Maineville, OH 45039-7092

Mailing address

487 Willow Pond Blvd Apt 104
Maineville, OH 45039-7092
Phone (513) 537-0433

Other providers in Maineville, OH

All providers in Maineville, OH · Personal Care Attendant in Ohio

Sources for this page

Verify at the official NPI Registry.