| NPI | 1346579422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN RANDALL CFO 513-454-1468 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35087657) |
| 208000000X Pediatrics (Licence: OH 35084869) | |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2023-11-03 |