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General NPI Number Information
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NPI Number | 1346104486
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Entity Type | Organization
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Legal Business Name | MIDWEST INTEGRATED CARE
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 775 W BROAD ST STE 260
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City | COLUMBUS
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State | OH
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Zip | 43222-1471
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Country | US
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Telephone | 614-289-8492
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Fax |
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Provider Business Mailing Address
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Address Line | 775 W BROAD ST STE 260
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City | COLUMBUS
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State | OH
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Zip | 43222-1471
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Country | US
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Telephone | 614-289-8492
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | BRIAN DEAN
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Credential |
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Telephone | 614-762-5206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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