| NPI | 1649786260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MARIE NIEMAN Director Of Credentialing 513-834-7063 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 251S00000X |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2023-08-01 |