Provider Demographics
NPI:1972655850
Name:CLERMONT ADULT RESIDENTIAL HOMES INC
Entity Type:Organization
Organization Name:CLERMONT ADULT RESIDENTIAL HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GRAEME
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:HOPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS EDUCATION
Authorized Official - Phone:513-732-6129
Mailing Address - Street 1:1710 US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-8653
Mailing Address - Country:US
Mailing Address - Phone:513-732-6129
Mailing Address - Fax:513-735-9115
Practice Address - Street 1:1710 US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-8653
Practice Address - Country:US
Practice Address - Phone:513-732-6129
Practice Address - Fax:513-735-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM1300274320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHM1300274Medicaid