Healthcare Provider Details

I. General information

NPI: 1033756846
Provider Name (Legal Business Name): JONAH'S CREATIVE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2019
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7819 W CHESTER RD
WEST CHESTER OH
45069-3728
US

IV. Provider business mailing address

7819 W CHESTER RD
WEST CHESTER OH
45069-3728
US

V. Phone/Fax

Practice location:
  • Phone: 513-602-4454
  • Fax:
Mailing address:
  • Phone: 513-602-4454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA STEWART
Title or Position: DIRECTOR
Credential:
Phone: 513-602-4454