Healthcare Provider Details

I. General information

NPI: 1154343630
Provider Name (Legal Business Name): TALBERT HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 VICTORY PKWY
CINCINNATI OH
45206-1711
US

IV. Provider business mailing address

2600 VICTORY PKWY
CINCINNATI OH
45206-1711
US

V. Phone/Fax

Practice location:
  • Phone: 513-221-4673
  • Fax: 513-751-0180
Mailing address:
  • Phone: 513-751-7747
  • Fax: 513-751-0180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM D HOSTLER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 513-751-7747