Healthcare Provider Details

I. General information

NPI: 1255593778
Provider Name (Legal Business Name): ALCOHOLISM COUNCIL OF THE CINCINNATI AREA NCADD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 VERNON PL 1ST FLOOR
CINCINNATI OH
45219-2414
US

IV. Provider business mailing address

2828 VERNON PL 1ST FLOOR
CINCINNATI OH
45219-2414
US

V. Phone/Fax

Practice location:
  • Phone: 513-281-7880
  • Fax: 513-281-7884
Mailing address:
  • Phone: 513-281-7880
  • Fax: 513-281-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: JOHN BILLERMAN
Title or Position: MIS
Credential:
Phone: 513-281-7880