Healthcare Provider Details

I. General information

NPI: 1033820535
Provider Name (Legal Business Name): SAVAGE SOLOMON NON- PROFIT CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
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: 513-822-3205
  • Fax: 513-822-3204
Mailing address:
  • Phone: 513-822-3205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DIANNE STEWART SOLOMON
Title or Position: CEO
Credential:
Phone: 513-771-1309