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General NPI Number Information
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NPI Number | 1710360474
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Entity Type | Organization
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Legal Business Name | ASSURANCE HEALTH CINCINNATI, LLC
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 11690 GROOMS RD
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City | BLUE ASH
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State | OH
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Zip | 45242-1412
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Country | US
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Telephone | 513-469-7800
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Fax | 513-469-9800
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Provider Business Mailing Address
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Address Line | 11690 GROOMS RD
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City | BLUE ASH
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State | OH
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Zip | 45242-1412
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Country | US
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Telephone | 765-374-6044
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Fax | 765-374-6043
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Authorized Official
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Title or Position | CEO
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Name | KYLE D SMALL
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Credential |
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Telephone | 317-372-6611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 07-7517
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 07-7512
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License Number State | OH
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