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NPI Code Detail

MEDICARE: CINCINNATIL LEADERSHIP ACADEMY

MEDICARE: CINCINNATIL LEADERSHIP ACADEMY
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
1251300000XLocal Education Agency (LEA)OH

General Provider Information

NPI Number : 1487844999
Entity Type Code : Organization
Provider Name (Legal Business Name) : CINCINNATIL LEADERSHIP ACADEMY
Provider Business Mailing Address
First Line : 7243 EASTLAWN DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3515
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7243 EASTLAWN DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3515
Country : US
Telephone Number : 513-351-5737
Fax Number :
Authorized Official
Title or Position : SCHOOL LEADER
Name : AUDLEY SMITH
Credential :
Telephone Number : 513-351-5737
Provider Enumeration Date : 07/31/2007
Last Update Date : 07/31/2007

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Directions to “CINCINNATIL LEADERSHIP ACADEMY ” Practice Location

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