Healthcare Provider Details

I. General information

NPI: 1962354613
Provider Name (Legal Business Name): OPEN YARD COMMUNITY SUPPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11427 REED HARTMAN HWY
BLUE ASH OH
45241-2418
US

IV. Provider business mailing address

11427 REED HARTMAN HWY
BLUE ASH OH
45241-2418
US

V. Phone/Fax

Practice location:
  • Phone: 267-626-4009
  • Fax:
Mailing address:
  • Phone: 267-626-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN KELECHI JACOB
Title or Position: OWNER
Credential: BA
Phone: 267-626-4009