| NPI | 1528828696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN RANDALL CFO 513-454-1468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2025-02-06 |