Organization
AMAZING GRACE RESIDENCIAL SERVICES LLC
Active
Other names
AMAZING GRACE RESIDENCIAL SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROLANDE TIEMENI (OWNER)
(513) 807-7950
Entity
Organization
Contact information
Practice address
522 SMILEY AVE, CINCINNATI, OH 45246-2220
(513) 807-7950
Mailing address
522 SMILEY AVE, CINCINNATI, OH 45246-2220
(513) 807-7950
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N
OH
01
—
0
0
—
Enumeration date
02/27/2023
Last updated
02/27/2023
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