| NPI | 1780475921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON CARUSO-FIELDS Owner Provider 513-560-2904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| 314000000X Skilled Nursing Facility | |
| 261QP2300X Clinic/Center, Primary Care | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| Enumeration Date | 2025-05-15 |
| Last Update Date | 2025-06-18 |