Healthcare Provider Details

I. General information

NPI: 1467255810
Provider Name (Legal Business Name): RDS ENTERPRISE OF OH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6792 KEENELAND WAY
MASON OH
45040-3420
US

IV. Provider business mailing address

6792 KEENELAND WAY
MASON OH
45040-3420
US

V. Phone/Fax

Practice location:
  • Phone: 513-773-6936
  • Fax:
Mailing address:
  • Phone: 513-773-6936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON L WERNER
Title or Position: OWNER
Credential:
Phone: 513-773-6936