Provider Demographics
NPI:1992141634
Name:YOU FIRST SUPPORTED LIVING, LLC
Entity type:Organization
Organization Name:YOU FIRST SUPPORTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRNITTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-322-2808
Mailing Address - Street 1:4218 COLERAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223
Mailing Address - Country:US
Mailing Address - Phone:513-322-2808
Mailing Address - Fax:513-322-2806
Practice Address - Street 1:4220 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-1902
Practice Address - Country:US
Practice Address - Phone:513-322-2808
Practice Address - Fax:513-322-2806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2972332Medicaid