Provider Demographics
NPI:1265743652
Name:CHILDREN'S PLANET III, LLC
Entity type:Organization
Organization Name:CHILDREN'S PLANET III, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-931-6500
Mailing Address - Street 1:7920 HAMILTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231
Mailing Address - Country:US
Mailing Address - Phone:513-931-6500
Mailing Address - Fax:513-931-6502
Practice Address - Street 1:7920 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2320
Practice Address - Country:US
Practice Address - Phone:513-931-6500
Practice Address - Fax:513-931-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3017112Medicaid
OH2934687Medicaid