| NPI | 1578078531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MARIE NIEMAN Director Payer Credentialing 513-544-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone (Licence: MD 102000) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2025-03-07 |