Provider Demographics
NPI:1922601657
Name:ACCLAIM COMMUNITY CARE LLC
Entity Type:Organization
Organization Name:ACCLAIM COMMUNITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHETMANY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-336-6133
Mailing Address - Street 1:7564 CENTRAL PARKE BLVD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6816
Mailing Address - Country:US
Mailing Address - Phone:513-336-6133
Mailing Address - Fax:513-336-6134
Practice Address - Street 1:7564 CENTRAL PARKE BLVD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6816
Practice Address - Country:US
Practice Address - Phone:513-336-6133
Practice Address - Fax:513-336-6134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0351218Medicaid