Healthcare Provider Details

I. General information

NPI: 1730937202
Provider Name (Legal Business Name): REALIZABLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 COMPTON RD
CINCINNATI OH
45231-3428
US

IV. Provider business mailing address

1580 COMPTON RD
CINCINNATI OH
45231-3428
US

V. Phone/Fax

Practice location:
  • Phone: 330-880-7714
  • Fax:
Mailing address:
  • Phone: 330-880-7714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: QUINETTA TUBBS
Title or Position: OWNER
Credential:
Phone: 513-692-0078