| NPI | 1861898934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY NIEMAN Director Of Credentialing 513-873-1269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MA 1942434311) |
| 261QH0100X Clinic/Center Health Service | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QM2800X Clinic/Center Methadone | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2024-09-30 |