Healthcare Provider Details

I. General information

NPI: 1710297734
Provider Name (Legal Business Name): NEIGHBORHOOD HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 PROSPECT PL
CINCINNATI OH
45229-2916
US

IV. Provider business mailing address

2415 AUBURN AVE
CINCINNATI OH
45219-2701
US

V. Phone/Fax

Practice location:
  • Phone: 513-363-5522
  • Fax:
Mailing address:
  • Phone: 513-221-4949
  • Fax: 513-241-4191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCIA A IRVING-RAY
Title or Position: CEO
Credential: DDS
Phone: 513-221-4949