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2100 Pleasant Ave Hamilton OH 45015-1133 | |
| (513) 868-1562 | |
| (513) 868-1415 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2100 Pleasant Ave, Hamilton, Ohio |
| Authorized Official Name and Position | Walter S Smitson (PRESIDENT / CEO) |
| Authorized Official Contact | 5135589015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2100 Pleasant Ave Hamilton OH 45015-1133 Ph: (513) 868-1562 | 2100 Pleasant Ave Hamilton OH 45015-1133 Ph: (513) 868-1562 |
| NPI Number | 1881954287 |
|---|---|
| Provider Enumeration Date | 05/21/2012 |
| Last Update Date | 05/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881954287 | NPI | - | NPPES |
| MC-07-04 | Medicaid | OH | |
| 41177 | Other | OH | CARF |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10057 (Ohio) | Primary |
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