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Organization

GREATER CINCINNATI CHILD DEVELOPMENT CENTER

Active
Parent organization
WESTSIDE RESIDENTIAL
Organization subpart
Yes

Provider details

NPI number
Legal business name
WESTSIDE RESIDENTIAL
Authorized official
SHAWNTAY CORISHA OLIVER (CEO/ OWNER)
(513) 407-6026
Entity
Organization

Contact information

Practice address
3516 HARRISON AVE, CINCINNATI, OH 45211-5595
(513) 407-6026
(513) 407-7101
Mailing address
3516 HARRISON AVE, CINCINNATI, OH 45211-5595
(513) 407-6026
(513) 407-7101

Taxonomy

Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
200780
OH

Other

Enumeration date
04/27/2015
Last updated
04/27/2015
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