| NPI | 1104057280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE MICHAEL ANDERSON Clinical Service Provider 513-932-4337 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |