| NPI | 1508343286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FULLER Director 513-389-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2021-02-19 |