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Organization
WESTSIDE RESIDENTIAL
Active
Organization
WESTSIDE RESIDENTIAL
Active
Parent organization
WESTSIDE RESIDENTIAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTSIDE RESIDENTIAL INC
Authorized official
MISS SHAWNTAY CORISHA OLIVER STNA (CEO/OWNER)
(513) 240-8757
Entity
Organization
Contact information
Practice address
3047 GLENWAY AVE, 6908 GOLW WAY DRIVE, CINCINNATI, OH 45204-1646
(513) 297-6575
(509) 756-8484
Mailing address
PO BOX 141233, CINCINNATI, OH 45250-1233
(513) 297-6575
(509) 756-8484
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/03/2007
Last updated
09/03/2007
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