Provider Demographics
NPI:1447029475
Name:PARENT PROMISE
Entity type:Organization
Organization Name:PARENT PROMISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-816-1546
Mailing Address - Street 1:3617 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-5504
Mailing Address - Country:US
Mailing Address - Phone:513-816-1546
Mailing Address - Fax:
Practice Address - Street 1:3646 GLENMORE AVE # 7
Practice Address - Street 2:
Practice Address - City:CHEVIOT
Practice Address - State:OH
Practice Address - Zip Code:45211-4730
Practice Address - Country:US
Practice Address - Phone:513-816-1546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No251B00000XAgenciesCase Management