Deairr Jamekia Broomes

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Cincinnati, OH

NPI 1104675339 · NPPES record last updated May 20, 2024

Key facts

NPI
1104675339
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Practice address
929 E McMillan St Apt 217
Cincinnati, OH 45206-3510
Phone
(513) 814-7775
NPI assigned
May 20, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

929 E McMillan St Apt 217
Cincinnati, OH 45206-3510

Mailing address

929 E McMillan St Apt 217
Cincinnati, OH 45206-3510
Phone (513) 814-7775

Other providers in Cincinnati, OH

All providers in Cincinnati, OH · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Ohio

Sources for this page

Verify at the official NPI Registry.