| NPI | 1679945497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANECIA L KING Supervising Nurse Practitioner 513-872-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OH PN.133958M-IV) |
| Additional Taxonomies | 251S00000X (Licence: OH PN133958M-IV) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2015-10-21 |