=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386886026
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHERISH LIFE INCORPORATED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2009
-----------------------------------------------------
Last Update Date | 03/26/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6411 OXFORD MILFORD RD
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45056-8896
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-523-6424
-----------------------------------------------------
Fax | 513-523-6424
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6411 OXFORD MILFORD RD
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45056-8896
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-523-6424
-----------------------------------------------------
Fax | 513-523-6424
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. CHERISH L. BOWMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 513-523-6424
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number | 0902027
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | 0902027
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------