Provider Demographics
NPI:1679338404
Name:OGLETREE SUPPORTIVE SERVICES LLC
Entity type:Organization
Organization Name:OGLETREE SUPPORTIVE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:OGLETREE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:513-310-5683
Mailing Address - Street 1:3443 AMBERWAY CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-3310
Mailing Address - Country:US
Mailing Address - Phone:513-310-5683
Mailing Address - Fax:
Practice Address - Street 1:3443 AMBERWAY CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-3310
Practice Address - Country:US
Practice Address - Phone:513-310-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty