Healthcare Provider Details

I. General information

NPI: 1861752263
Provider Name (Legal Business Name): COMMUNITY BEHAVIORAL HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S MARTIN LUTHER KING JR BLVD
HAMILTON OH
45011-3216
US

IV. Provider business mailing address

230 LUDLOW ST
HAMILTON OH
45011-2903
US

V. Phone/Fax

Practice location:
  • Phone: 513-887-8500
  • Fax: 513-737-8196
Mailing address:
  • Phone: 513-785-4782
  • Fax: 513-785-4789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARK ZOELLNER
Title or Position: CFO
Credential:
Phone: 513-785-4742