MEDICARE: P.A.C.E. EMPOWERMENT CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1306086038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	P.A.C.E. EMPOWERMENT CORPORATION

Provider Business Mailing Address
First Line	:	1601 CALIFORNIA AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-5603
Country	:	US
Telephone Number	:	513-751-7223
Fax Number	:	513-482-3322

Provider Business Practice Location Address
First Line	:	1601 CALIFORNIA AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-5603
Country	:	US
Telephone Number	:	513-751-7223
Fax Number	:	513-482-3322

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. STEVEN C HAWLEY
Credential	:	ED.D.
Telephone Number	:	513-751-7223

Provider Enumeration Date	:	02/20/2009
Last Update Date	:	02/20/2009

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