| NPI | 1235909367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MARIE NIEMAN Director Of Payer Credentialing 513-544-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2026-09-03 |