1285097618 NPI number — CINCINNATI TREATMENT & COUNSELING CENTER

Table of content: (NPI 1285097618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285097618 NPI number — CINCINNATI TREATMENT & COUNSELING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CINCINNATI TREATMENT & COUNSELING CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CINCINNATI TREATMENT CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285097618
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3041 SYMMES RD
Provider Second Line Business Mailing Address:
UNIT D
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45015-1395
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-860-9888
Provider Business Mailing Address Fax Number:
513-860-2268

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3041 SYMMES RD
Provider Second Line Business Practice Location Address:
UNIT D
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45015-1395
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-860-9888
Provider Business Practice Location Address Fax Number:
513-860-2268
Provider Enumeration Date:
04/02/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SILVANI
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
STEPHEN
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
513-479-3952

Provider Taxonomy Codes

  • Taxonomy code: 103TA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)