PHILLIP'N ELIZABETH CLINICAL STAFFING (NPI# 1790397016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790397016 |
| Entity Type | Organization |
| Organization Name | PHILLIP'N ELIZABETH CLINICAL STAFFING |
| Practice Address |
4134 Linden Ave Ste 306 Dayton OH 45432-3035 |
| Mailing Address |
6455 E Livingston Ave Reynoldsburg OH 43068-3589 |
| Practice Telephone | 6143145416 |
| Practice Fax Number | 6148618842 |
| Mailing Telephone | 6143145416 |
| Mailing Fax Number | 6148618842 |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |
| Authorized Official Name | MS. GRACE FONGOD (CEO) |
| Authorized Official Telephone | 6143145416 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| Street Address |
4134 LINDEN AVE STE 306 |
| City | DAYTON |
| State | OH |
| Zip Code | 45432-3035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538789284 | Shannon Davis Kaufman | Counselor | National Youth Advocate Program, 1020 Woodman Drive Suite 330, Dayton, OH 45432 | 2020-04-23 |
| 1215480504 | Heather Iaquinta | Registered Nurse | 1430 Linden Ave., Suite 390, Dayton, OH 45432 | 2016-08-03 |
| 1346586682 | Jeffrey Craig Miller | Dentist | 4450 Linden Ave., Dayton, OH 45432 | 2012-12-13 |
| 1194997718 | Paul G Tarlano Dds Inc | Dentist | 3621 Dayton-xenia Rd, Beaver Creek, OH 45432 | 2008-03-25 |
| 1306018981 | Paul Gerald Tarlano | Dentist | 3621 Dayton Xenia Rd, Beavercreek, OH 45432 | 2008-03-24 |
| 1104035377 | Andrew Brody | Occupational Therapy Assistant | 1974 North Fairfield Road, Beavercreek, OH 45432 | 2007-05-22 |
| 1952476111 | Jeffrey C Miller Dds Inc | Dentist | 4450 Linden Ave, Dayton, OH 45432 | 2006-11-22 |
| 1194898098 | Joseph Warren Shiveley | Dentist | 1555 Marsetta Drive, Dayton, OH 45432 | 2006-11-16 |
| 1710907597 | Integrated Youth Services Inc | Clinic/Center | 1321 Research Park Drive, Dayton, OH 45432 | 2006-07-21 |
| 1730106790 | Lorena L Kvalheim | Psychologist | 1020 Woodman Street, Suite 300, Dayton, OH 45432 | 2006-07-16 |
| Find all providers in zip 45432 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1194292912 | Occupational Health Centers of Ohio, Pa Co | Clinic/Center | 7010 Spring Meadows Dr W Ste 101, Holland, OH 43528-8137 | 2018-10-30 |
| 1295220424 | Shanteya Cunningham | Clinic/Center | 3481 Robb Ave, Cincinnati, OH 45211-5340 | 2018-06-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.