| NPI | 1083326706 |
|---|---|
| Former Legal Business Name | RESEREVELATIONS, LLC |
| Entity Type | Organization |
| Authorized Contact | DE'RESE ZYIRE GOODEN Licensed Professional Counselor 513-328-8516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2022-12-17 |