| NPI | 1063164655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY SPAULDING Credentialing COO Rdinator 513-941-4999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-03-23 |