MEDICARE: GIVE ME A BREAK RESPITE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	385HR2055X	Child Mental Illness Respite Care
2	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
3	385HR2065X	Child Physical Disabilities Respite Care
4	385H00000X	Respite Care

General Provider Information

NPI Number	:	1740082601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIVE ME A BREAK RESPITE LLC

Provider Business Mailing Address
First Line	:	PO BOX 5042
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45205-0042
Country	:	US
Telephone Number	:	513-278-7667
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 BEECH AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45205-1648
Country	:	US
Telephone Number	:	513-375-8967
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. STACEY L JONES
Credential	:
Telephone Number	:	513-278-7667

Provider Enumeration Date	:	03/24/2025
Last Update Date	:	03/24/2025

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