Healthcare Provider Details

I. General information

NPI: 1083527915
Provider Name (Legal Business Name): REGENERATION SCHOOLS - AVONDALE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3595 WASHINGTON AVE
CINCINNATI OH
45229-2617
US

IV. Provider business mailing address

3595 WASHINGTON AVE
CINCINNATI OH
45229-2617
US

V. Phone/Fax

Practice location:
  • Phone: 513-351-5801
  • Fax:
Mailing address:
  • Phone: 513-351-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MITCHELL ELATKIN
Title or Position: SENIOR DIRECTOR OF SPECIALIZED SERV
Credential:
Phone: 773-930-6843