Healthcare Provider Details

I. General information

NPI: 1437002763
Provider Name (Legal Business Name): ST VOLTAIRE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 DEWDROP CIR APT C
CINCINNATI OH
45240-3799
US

IV. Provider business mailing address

489 DEWDROP CIR APT C
CINCINNATI OH
45240-3799
US

V. Phone/Fax

Practice location:
  • Phone: 513-394-8035
  • Fax:
Mailing address:
  • Phone: 513-394-8035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State

VIII. Authorized Official

Name: DR. LAVAR DEON MACK I
Title or Position: PRESIDENT
Credential: MD
Phone: 513-394-8035