MEDICARE: ACTS 1:8 HOUSING

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	251B00000X	Case Management Agency
2	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1982338059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTS 1:8 HOUSING

Provider Business Mailing Address
First Line	:	1286 SIMMONS AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2327
Country	:	US
Telephone Number	:	513-554-2287
Fax Number	:	513-586-0839

Provider Business Practice Location Address
First Line	:	1286 SIMMONS AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2327
Country	:	US
Telephone Number	:	513-554-2287
Fax Number	:	513-586-0839

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JERRHONDA ANNE STALLWORTH
Credential	:	BACHELORS
Telephone Number	:	513-554-2287

Provider Enumeration Date	:	07/13/2022
Last Update Date	:	08/23/2022

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Directions to “ACTS 1:8 HOUSING ” Practice Location

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