Healthcare Provider Details

I. General information

NPI: 1457222994
Provider Name (Legal Business Name): ISRAEL EYI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6432 REDMONT CT
LIBERTY TOWNSHIP OH
45044-8645
US

IV. Provider business mailing address

6432 REDMONT CT
LIBERTY TOWNSHIP OH
45044-8645
US

V. Phone/Fax

Practice location:
  • Phone: 513-372-5262
  • Fax:
Mailing address:
  • Phone: 513-372-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: