Healthcare Provider Details

I. General information

NPI: 1679759377
Provider Name (Legal Business Name): FRONT LEASING CO., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 FRONT ST
BEREA OH
44017-1943
US

IV. Provider business mailing address

4700 ASHWOOD DR SUITE 200
CINCINNATI OH
45241-2465
US

V. Phone/Fax

Practice location:
  • Phone: 440-243-4000
  • Fax: 440-891-3446
Mailing address:
  • Phone: 513-489-7100
  • Fax: 513-489-7199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number25392
License Number StateOH

VIII. Authorized Official

Name: MS. MONICA RENEE HUMBERT
Title or Position: EXECUTIVE ASSISTANT TO CFO
Credential:
Phone: 513-530-1622