MEDICARE: CINCINNATI ACHIEVEMENT 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
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1831721109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATI ACHIEVEMENT ACADEMY

Provider Business Mailing Address
First Line	:	1814 S MAIN ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44301-2451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 LITTLE FLOWER AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-6807
Country	:	US
Telephone Number	:	513-975-4946
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR-OEC, EEG
Name	:	MEAGHAN BUSH
Credential	:
Telephone Number	:	440-429-0563

Provider Enumeration Date	:	02/05/2020
Last Update Date	:	10/19/2021

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