Provider Demographics
NPI:1154865400
Name:YOUR WELCOME HOUSE
Entity type:Organization
Organization Name:YOUR WELCOME HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCDCII DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VENITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:LCDCII
Authorized Official - Phone:513-623-1343
Mailing Address - Street 1:11332 LINCOLNSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240
Mailing Address - Country:US
Mailing Address - Phone:513-623-1343
Mailing Address - Fax:
Practice Address - Street 1:11332 LINCOLNSHIRE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-2339
Practice Address - Country:US
Practice Address - Phone:513-623-1343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH141305251B00000X, 291U00000X, 324500000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251B00000XAgenciesCase Management
No291U00000XLaboratoriesClinical Medical Laboratory
No347C00000XTransportation ServicesPrivate Vehicle