Provider Demographics
NPI:1780027516
Name:ASSOCIATED HEALTHCARE OF OHIO
Entity Type:Organization
Organization Name:ASSOCIATED HEALTHCARE OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:513-671-3500
Mailing Address - Street 1:1329 E KEMPER RD STE 4100A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-5100
Mailing Address - Country:US
Mailing Address - Phone:513-671-3500
Mailing Address - Fax:513-671-3535
Practice Address - Street 1:1329 E KEMPER RD STE 4100A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-5100
Practice Address - Country:US
Practice Address - Phone:513-671-3500
Practice Address - Fax:513-671-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM5980514251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHM9801594Medicaid