| NPI | 1063916948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN DUANE JOHNSON Owner/CEO 513-221-9982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 251S00000X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-07-30 |