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General NPI Number Information
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NPI Number | 1194464081
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Entity Type | Organization
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Legal Business Name | HUBER HEIGHTS HOLDINGS, LLC
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 6210 BELLEFONTAINE RD
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-4009
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Country | US
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Telephone | 937-236-1800
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Fax | 937-347-5912
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Provider Business Mailing Address
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Address Line | 6210 BELLEFONTAINE RD
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City | DAYTON
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State | OH
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Zip | 45424-4009
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Country | US
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Telephone | 937-236-1800
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Fax | 937-701-6910
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Authorized Official
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Title or Position | CEO
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Name | RACHEL E COSTELLO
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Credential | PH.D., MS. LPCC-S
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Telephone | 937-231-1838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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