Organization
COFFEE CARAVAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TITMAS (PRESIDENT/DOO)
(513) 680-2640
Entity
Organization
Contact information
Practice address
706 DEERFIELD RD, LEBANON, OH 45036-2444
(513) 680-2640
Mailing address
706 DEERFIELD RD, LEBANON, OH 45036-2444
(513) 680-2640
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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