Healthcare Provider Details

I. General information

NPI: 1104220490
Provider Name (Legal Business Name): ST. ALOYSIUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2014
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S COLLEGE AVE
OXFORD OH
45056-1738
US

IV. Provider business mailing address

4721 READING RD
CINCINNATI OH
45237-6107
US

V. Phone/Fax

Practice location:
  • Phone: 513-242-7600
  • Fax:
Mailing address:
  • Phone: 513-242-7600
  • Fax: 513-242-2845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CARRIE HAMPTON
Title or Position: QI DIRECTOR
Credential:
Phone: 513-242-3536