Organization
THE LODGE ACTIVITY CENTER LLC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CELENA V PARKER (CEO)
(513) 291-0974
Entity
Organization
Contact information
Practice address
1390 EATON AVE, HAMILTON, OH 45013-1407
(513) 291-0974
Mailing address
654 HISTORY BRIDGE LN, HAMILTON, OH 45013-3660
(513) 291-0974
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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