| NPI | 1003289166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VARONICA FREEMAN Billing Manager 513-260-9643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6801011245) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI SA0823273) |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: MI SA0823273) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MI SA0823273) | |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2022-07-21 |