Provider Demographics
NPI:1083468474
Name:TASHAY JOHNNY & ADDIES WAY LLC
Entity Type:Organization
Organization Name:TASHAY JOHNNY & ADDIES WAY LLC
Other - Org Name:TASHAY JOHNNY & ADDIES WAY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOO
Authorized Official - Prefix:MS
Authorized Official - First Name:CORLISS
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-746-8277
Mailing Address - Street 1:8980 TRIPOLI DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-3063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8980 TRIPOLI DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-3063
Practice Address - Country:US
Practice Address - Phone:513-746-8277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child