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General NPI Number Information
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NPI Number | 1205321049
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Entity Type | Organization
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Legal Business Name | PAX TREATMENT CENTERS LLC
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 4302 ROOSEVELT BLVD
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City | MIDDLETOWN
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State | OH
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Zip | 45044-6625
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Country | US
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Telephone | 513-433-1032
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Fax |
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Provider Business Mailing Address
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Address Line | 4302 ROOSEVELT BLVD
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City | MIDDLETOWN
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State | OH
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Zip | 45044-6625
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Country | US
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Telephone | 513-433-1032
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISS MARY SILVANI
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Credential | RN MAED
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Telephone | 513-607-2099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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