MEDICARE: COMMUNITY IMPACT, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	171M00000X	Case Manager/Care Coordinator
3	261QB0400X	Birthing Clinic/Center
4	261QP2300X	Primary Care Clinic/Center
5	251V00000X	Voluntary or Charitable Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740283282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY IMPACT, INC.

Provider Business Mailing Address
First Line	:	700 W PETE ROSE WAY
Second Line	:	SUITE 350
City	:	CINCINNATI
State	:	OH
Zip	:	45203-1875
Country	:	US
Telephone Number	:	513-319-3325
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 W PETE ROSE WAY
Second Line	:	SUITE 350
City	:	CINCINNATI
State	:	OH
Zip	:	45203-1892
Country	:	US
Telephone Number	:	513-319-3325
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. CHARLES E MYLES
Credential	:	B.S.
Telephone Number	:	513-319-3325

Provider Enumeration Date	:	05/29/2005
Last Update Date	:	07/14/2014

Similar Medicare Providers

1063652527 — DECLARE THERAPY CENTER INC
Practice Location Address:

700 W PETE ROSE WAY
CINCINNATI, OH
45203-1892

Practice Phone: 513-290-7908
Practice Fax: 513-834-7052

1427482645 — JOANN EUGENIA ERBY PTA
Practice Location Address:

700 W PETE ROSE WAY
CINCINNATI, OH
45203-1892

Practice Phone: 513-381-3380
Practice Fax:

1790115079 — MATTHEW ALLARD
Practice Location Address:

700 W PETE ROSE WAY , #225
CINCINNATI, OH
45203-1892

Practice Phone: 888-752-9640
Practice Fax:

1659778595 — KELLY MOFFITT
Practice Location Address:

700 W PETE ROSE WAY , SUITE 225
CINCINNATI, OH
45203-1892

Practice Phone: 513-381-3380
Practice Fax:

1033590914 — KATHERINE STOLL LPC-CR, CDCA 1
Practice Location Address:

700 W PETE ROSE WAY , SUITE 349
CINCINNATI, OH
45203-1892

Practice Phone: 513-834-7050
Practice Fax: 513-834-7052

1992255731 — MISS CYNTHIA VANDEILEN OTR/L
Practice Location Address:

700 W PETE ROSE WAY
CINCINNATI, OH
45203-1892

Practice Phone: 513-381-3380
Practice Fax:

Directions to “COMMUNITY IMPACT, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.