Provider Demographics
NPI:1730905837
Name:OTB HOME FOUNDATION
Entity type:Organization
Organization Name:OTB HOME FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYNAMON
Authorized Official - Middle Name:BRANDI DENISE
Authorized Official - Last Name:ROSEMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-344-9600
Mailing Address - Street 1:2672 MONTANA AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-3730
Mailing Address - Country:US
Mailing Address - Phone:513-344-9600
Mailing Address - Fax:
Practice Address - Street 1:2672 MONTANA AVE APT 14
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-3730
Practice Address - Country:US
Practice Address - Phone:513-344-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-23
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management