1932719085 NPI number — THE ROAD TO ENDURANCE COUNSELING SERVICES, LLC

Table of content: (NPI 1932719085)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932719085 NPI number — THE ROAD TO ENDURANCE COUNSELING SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE ROAD TO ENDURANCE COUNSELING SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
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NPI Number Information

NPI Number:
1932719085
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10999 REED HARTMAN HWY STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUE ASH
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45242-8301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-802-9582
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8857 CINCINNATI DAYTON RD STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST CHESTER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45069-3192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-802-9582
Provider Business Practice Location Address Fax Number:
513-802-9582
Provider Enumeration Date:
08/04/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
AJITA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
301-661-3481

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)