Healthcare Provider Details

I. General information

NPI: 1093313561
Provider Name (Legal Business Name): LINCOLN HEIGHTS OUTREACH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9931 WAYNE AVE
CINCINNATI OH
45215-1407
US

IV. Provider business mailing address

9931 WAYNE AVE
CINCINNATI OH
45215-1407
US

V. Phone/Fax

Practice location:
  • Phone: 513-554-4455
  • Fax:
Mailing address:
  • Phone: 513-554-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT L ROBINSON
Title or Position: BOARD CHAIRMAN
Credential:
Phone: 513-673-6393