Healthcare Provider Details

I. General information

NPI: 1710691795
Provider Name (Legal Business Name): COMMUNITY BEHAVIORAL HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 ALEXANDRIA PIKE STE 104
FORT THOMAS KY
41075-2561
US

IV. Provider business mailing address

230 LUDLOW ST
HAMILTON OH
45011-2903
US

V. Phone/Fax

Practice location:
  • Phone: 513-785-4785
  • Fax:
Mailing address:
  • Phone: 513-785-4785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRIAN KRAUSE
Title or Position: CFO
Credential:
Phone: 513-785-4054