| NPI | 1467068262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL FARRELL Owner 513-923-6336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 3104A0625X Assisted Living Facility Assisted Living, Mental Illness | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2021-01-16 |