Healthcare Provider Details
I. General information
NPI: 1538960950
Provider Name (Legal Business Name): RHIZOME THERAPY COOPERATIVE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
605 BURNS ST
CINCINNATI OH
45204-1942
US
IV. Provider business mailing address
605 BURNS ST
CINCINNATI OH
45204-1942
US
V. Phone/Fax
- Phone: 513-409-0808
- Fax:
- Phone: 513-205-3059
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NERN
EARNEST
OSTENDORF
Title or Position: THERAPIST, FOUNDER
Credential: LISW
Phone: 513-205-3059