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General NPI Number Information
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NPI Number | 1245922988
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Entity Type | Organization
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Legal Business Name | SOME ONES SON
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 4973 GLENWAY AVE
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City | CINCINNATI
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State | OH
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Zip | 45238-3907
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Country | US
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Telephone | 513-386-9362
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Fax |
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Provider Business Mailing Address
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Address Line | 4824 APPALOOSA TRL
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City | MASON
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State | OH
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Zip | 45040-9119
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Country | US
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Telephone | 937-707-2725
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CONNIE KNIGHT
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Credential | LPN
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Telephone | 937-707-2725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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