Healthcare Provider Details

I. General information

NPI: 1700682143
Provider Name (Legal Business Name): K CS CALMING RETREAT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1859 WOODS HOLE RD
PERRYSBURG OH
43551-2182
US

IV. Provider business mailing address

1859 WOODS HOLE RD
PERRYSBURG OH
43551-2182
US

V. Phone/Fax

Practice location:
  • Phone: 419-455-3489
  • Fax:
Mailing address:
  • Phone: 419-455-3489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KATRINA BRAGG
Title or Position: OWNER
Credential:
Phone: 419-455-3489