Healthcare Provider Details

I. General information

NPI: 1043277759
Provider Name (Legal Business Name): CLERMONT RECOVERY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 WASSERMAN WAY SUITE C
BATAVIA OH
45103-1911
US

IV. Provider business mailing address

1088 WASSERMAN WAY SUITE C
BATAVIA OH
45103-1911
US

V. Phone/Fax

Practice location:
  • Phone: 513-735-8100
  • Fax: 513-735-8156
Mailing address:
  • Phone: 513-735-8100
  • Fax: 513-735-8156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN M. GOLDSBERRY
Title or Position: PRESIDENT/CEO
Credential: LISW, LICDC
Phone: 513-735-8100