Healthcare Provider Details

I. General information

NPI: 1871240929
Provider Name (Legal Business Name): NYCE OPTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2176 FENWICK RD
UNIVERSITY HT OH
44118-3116
US

IV. Provider business mailing address

2176 FENWICK RD
UNIVERSITY HT OH
44118-3116
US

V. Phone/Fax

Practice location:
  • Phone: 216-273-1211
  • Fax:
Mailing address:
  • Phone: 419-309-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KENDRA G ZIMMERMAN
Title or Position: CEO
Credential:
Phone: 419-309-8883