Organization
IN LIVING SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEDRA TAYLOR (PRESIDENT)
(513) 545-0098
Entity
Organization
Contact information
Practice address
230 NORTHLAND BLVD, SUITE 134, CINCINNATI, OH 45246-3675
(513) 545-0098
(513) 834-5270
Mailing address
230 NORTHLAND BLVD, SUITE 134, CINCINNATI, OH 45246-3675
(513) 545-0098
(513) 834-5270
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1718045
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2755184
—
OH
Enumeration date
04/26/2011
Last updated
04/26/2011
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