| NPI | 1982317442 |
|---|---|
| Former Legal Business Name | EARTHSIDE HEALTH AND WELLNESS LLC |
| Entity Type | Organization |
| Authorized Contact | TAYLOR SCHROEDER Owner 513-305-9093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2024-05-09 |