Provider Demographics
NPI:1043021280
Name:MOSELY'S CARE LIVING SPACE LLC
Entity type:Organization
Organization Name:MOSELY'S CARE LIVING SPACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIEWINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-237-2028
Mailing Address - Street 1:2922 DEBRECK AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-7804
Mailing Address - Country:US
Mailing Address - Phone:513-237-2028
Mailing Address - Fax:
Practice Address - Street 1:2922 DEBRECK AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-7804
Practice Address - Country:US
Practice Address - Phone:513-237-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health