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General NPI Number Information
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NPI Number | 1699857425
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Entity Type | Organization
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Legal Business Name | CENTER HAVEN INC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 422 N 2ND ST
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City | HAMILTON
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State | OH
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Zip | 45011-1602
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Country | US
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Telephone | 513-868-9600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 267
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City | HAMILTON
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State | OH
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Zip | 45012-0267
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Country | US
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Telephone | 513-868-9600
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Fax | 513-868-1174
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES H GENTRY
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Credential | NHA
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Telephone | 513-868-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 6323
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License Number State | OH
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