MEDICARE: TALBERT HOUSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548288350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALBERT HOUSE

Provider Business Mailing Address
First Line	:	2600 VICTORY PKWY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1711
Country	:	US
Telephone Number	:	513-751-7747
Fax Number	:	513-751-0180

Provider Business Practice Location Address
First Line	:	9018 CINCINNATI COLUMBUS RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-3565
Country	:	US
Telephone Number	:	513-755-8133
Fax Number	:	513-755-8185

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. WILLIAM D HOSTLER
Credential	:
Telephone Number	:	513-751-7747

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	08/05/2014

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Directions to “TALBERT HOUSE ” Practice Location

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