Healthcare Provider Details

I. General information

NPI: 1912595679
Provider Name (Legal Business Name): MKS RECOVERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 TRI COUNTY PKWY STE 237
CINCINNATI OH
45246-3238
US

IV. Provider business mailing address

155 TRICOUNTY PKWY SUITE 237
CINCINNATI OH
45246
US

V. Phone/Fax

Practice location:
  • Phone: 513-345-0195
  • Fax:
Mailing address:
  • Phone: 513-345-0195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MATTHEW K OGLETREE
Title or Position: CEO
Credential:
Phone: 513-345-0195