Provider Demographics
NPI:1639769680
Name:NIKAS GROUP HOME LLC
Entity Type:Organization
Organization Name:NIKAS GROUP HOME LLC
Other - Org Name:NIKAS HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-550-7449
Mailing Address - Street 1:PO BOX 58130
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45258-0130
Mailing Address - Country:US
Mailing Address - Phone:513-244-1562
Mailing Address - Fax:
Practice Address - Street 1:2611 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-3768
Practice Address - Country:US
Practice Address - Phone:513-244-1562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NIKAS GROUP HOME LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-24
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children