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NPI 1164014866 · Emotionally Disturbed Childrens' Residential Treatment Facility · Cincinnati, OH
Provider details
- NPI number
- 1164014866
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Detra Jett, Chief Executive Officer(513) 225-9609
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3493 Craig Ave
Cincinnati, OH 45211-5727
Phone: (513) 225-9609
Fax: (513) 813-3032
Street-level locationGet directions
Mailing address
3493 Craig Ave
Cincinnati, OH 45211-5727
Registry dates
- Enumerated
- 2021-02-04
- Last updated
- 2021-02-04
- Certified
- 2021-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.