| The Resident Home Corporation | |
|
3030 W Fork Rd Cincinnati OH 45211 | |
| (513) 389-7500 | |
| (513) 389-7508 |
| Full Name | The Resident Home Corporation |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3030 W Fork Rd, Cincinnati, Ohio |
| Authorized Official Name and Position | James Steffey (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5133897500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Resident Home Corporation 3030 W Fork Rd Cincinnati OH 45211-1944 Ph: (513) 389-7500 | The Resident Home Corporation 3030 W Fork Rd Cincinnati OH 45211 Ph: (513) 389-7500 |
| NPI Number | 1508111410 |
|---|---|
| Provider Enumeration Date | 07/17/2012 |
| Last Update Date | 05/30/2018 |
| Medicare PECOS PAC ID | 9537424064 |
|---|---|
| Medicare Enrollment ID | O20180604000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508111410 | NPI | - | NPPES |
| 3100218 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sarah E Rissler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033579669 PECOS PAC ID: 2668736851 Enrollment ID: I20180516002444 |
| Provider Name | Carissa M Blatz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609370329 PECOS PAC ID: 5496000689 Enrollment ID: I20180612000143 |
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