Healthcare Provider Details
I. General information
NPI: 1780912618
Provider Name (Legal Business Name): COMMUNITY HEALTH, FAMILY COUNSELING, EDUCATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2009
Last Update Date: 12/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3284 N BEND RD SUITE 310B
CINCINNATI OH
45239-7688
US
IV. Provider business mailing address
3284 N BEND RD SUITE 310B
CINCINNATI OH
45239-7688
US
V. Phone/Fax
- Phone: 513-481-2432
- Fax: 513-662-2432
- Phone: 513-481-2432
- Fax: 513-662-2432
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 944096 |
| License Number State | OH |
VIII. Authorized Official
Name:
ROLAND
M
HEYNE
Title or Position: PRESIDENT
Credential: LICDC, OCPS II
Phone: 513-481-2432