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9403 Kenwood Rd # C-212 Blue Ash OH 45242-6895 | |
| (513) 792-1272 | |
| (513) 891-4449 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9403 Kenwood Rd # C-212, Blue Ash, Ohio |
| Authorized Official Name and Position | Elissa Mazer (DIRECTOR OF BUSINESS OPERATIONS) |
| Authorized Official Contact | 5137921272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9403 Kenwood Rd # C-212 Blue Ash OH 45242-6895 Ph: (513) 792-1272 | 9403 Kenwood Rd # C-212 Blue Ash OH 45242-6895 Ph: (513) 792-1272 |
| NPI Number | 1255517959 |
|---|---|
| Provider Enumeration Date | 01/14/2008 |
| Last Update Date | 01/16/2025 |
| Certification Date | 01/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255517959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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