Healthcare Provider Details

I. General information

NPI: 1760130926
Provider Name (Legal Business Name): RECOVERY CENTER OF HAMILTON COUNTY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MADISON RD BASEMENT LEVEL
CINCINNATI OH
45206
US

IV. Provider business mailing address

2340 AUBURN AVE
CINCINNATI OH
45219-2802
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-5200
  • Fax:
Mailing address:
  • Phone: 513-241-1411
  • Fax: 513-241-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRIS PEDOTO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 513-532-4895