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 |