Healthcare Provider Details

I. General information

NPI: 1902399959
Provider Name (Legal Business Name): DANIEL ROVIRA QMHS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROSS PARK BLVD STE 201
STEUBENVILLE OH
43952-2671
US

IV. Provider business mailing address

1 ROSS PARK BLVD STE 201
STEUBENVILLE OH
43952-2671
US

V. Phone/Fax

Practice location:
  • Phone: 740-264-7751
  • Fax: 740-264-2422
Mailing address:
  • Phone: 740-264-7751
  • Fax: 740-264-2422

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:
Title or Position:
Credential:
Phone: