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General NPI Number Information
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NPI Number | 1568161420
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Entity Type | Organization
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Legal Business Name | ANDIAMO HEALTHCARE
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 12/18/2023
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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 | 330-329-7980
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Fax |
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Provider Business Mailing Address
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Address Line | 5710 STONE LAKE DR
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City | CENTERVILLE
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State | OH
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Zip | 45429-6053
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Country | US
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Telephone | 330-329-7980
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. ANGELA M PALITTO
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Credential | DO
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Telephone | 330-329-7980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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