Healthcare Provider Details

I. General information

NPI: 1902751597
Provider Name (Legal Business Name): PRINCIPLE HEALTHCARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2026
Last Update Date: 02/28/2026
Certification Date: 02/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6679 BALSAM DR
BEDFORD HEIGHTS OH
44146-4804
US

IV. Provider business mailing address

6679 BALSAM DR
BEDFORD HEIGHTS OH
44146-4804
US

V. Phone/Fax

Practice location:
  • Phone: 407-450-4549
  • Fax:
Mailing address:
  • Phone: 407-450-4549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: JERROLD A JOHNSON
Title or Position: PRESIDENT
Credential:
Phone: 407-450-4549