MEDICARE: GREATER CINCINNATI OFFICE OF REENTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YP1600X	Pastoral Counselor
2	251S00000X	Community/Behavioral Health Agency
3	251V00000X	Voluntary or Charitable Agency
4	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1548127343
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER CINCINNATI OFFICE OF REENTRY

Provider Business Mailing Address
First Line	:	10650 FORESTDALE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-4009
Country	:	US
Telephone Number	:	513-836-1275
Fax Number	:

Provider Business Practice Location Address
First Line	:	2140 WAYCROSS RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-2719
Country	:	US
Telephone Number	:	513-836-1275
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	LISA M YOUNGBLOOD
Credential	:
Telephone Number	:	513-836-1275

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “GREATER CINCINNATI OFFICE OF REENTRY ” Practice Location

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