Provider Demographics
NPI:1477211423
Name:BLUE HEART SERVICES LLC
Entity Type:Organization
Organization Name:BLUE HEART SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-903-6559
Mailing Address - Street 1:801 EVANS ST STE 104
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45204-2075
Mailing Address - Country:US
Mailing Address - Phone:513-903-6559
Mailing Address - Fax:
Practice Address - Street 1:4973 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3907
Practice Address - Country:US
Practice Address - Phone:513-790-3033
Practice Address - Fax:513-995-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1215430293OtherNPI