MEDICARE: S&M AGENCY

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1467888743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S&M AGENCY

Provider Business Mailing Address
First Line	:	PO BOX 112231
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-2231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2867 ORLAND AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-8020
Country	:	US
Telephone Number	:	513-417-6934
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SANDRA TOLLIVER
Credential	:
Telephone Number	:	513-417-6934

Provider Enumeration Date	:	09/18/2013
Last Update Date	:	09/18/2013

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Directions to “S&M AGENCY ” Practice Location

Language	Start Address	Practice Location

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