| NPI | 1417643669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MARIE NIEMAN Director Of Credentialing 513-834-7063 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |