Healthcare Provider Details

I. General information

NPI: 1821476268
Provider Name (Legal Business Name): CEDAR KNOLL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11275 SPRINGFIELD PIKE
CINCINNATI OH
45246-4113
US

IV. Provider business mailing address

11275 SPRINGFIELD PIKE
CINCINNATI OH
45246-4113
US

V. Phone/Fax

Practice location:
  • Phone: 513-782-2546
  • Fax: 513-782-8306
Mailing address:
  • Phone: 513-782-2546
  • Fax: 513-782-8306

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: LINTON SHARPNACK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 513-782-2546