Provider Demographics
NPI:1619068434
Name:QUEEN CITY SENIORS INC
Entity Type:Organization
Organization Name:QUEEN CITY SENIORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:REISING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-836-2904
Mailing Address - Street 1:675 DEIS DR
Mailing Address - Street 2:#105
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-8136
Mailing Address - Country:US
Mailing Address - Phone:513-247-0013
Mailing Address - Fax:513-247-0081
Practice Address - Street 1:6355 E KEMPER RD
Practice Address - Street 2:SUITE LL1
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2380
Practice Address - Country:US
Practice Address - Phone:513-247-0013
Practice Address - Fax:513-247-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTAX IDENTIFICATION NUMBER