Provider Demographics
NPI:1609392950
Name:CORE EDUCATION AND MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:CORE EDUCATION AND MENTAL HEALTH SERVICES
Other - Org Name:CORE EDUCATIONAL SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BALLEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-655-5027
Mailing Address - Street 1:7672 MONTGOMERY RD #121
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4204
Mailing Address - Country:US
Mailing Address - Phone:513-655-5027
Mailing Address - Fax:513-239-3015
Practice Address - Street 1:608 E MCMILLAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1926
Practice Address - Country:US
Practice Address - Phone:513-375-4275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health