Healthcare Provider Details

I. General information

NPI: 1902724792
Provider Name (Legal Business Name): KEYSTONE POTENTIAL FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11969 EIDER DR
CINCINNATI OH
45246-1531
US

IV. Provider business mailing address

11969 EIDER DR
CINCINNATI OH
45246-1531
US

V. Phone/Fax

Practice location:
  • Phone: 513-307-3152
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DENA COMBS
Title or Position: PRESIDENT
Credential:
Phone: 513-307-3152