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General NPI Number Information
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NPI Number | 1710775549
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOSPITAL MEDICAL CENTER
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 5642 HAMILTON AVE
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City | CINCINNATI
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State | OH
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Zip | 45224-3114
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Country | US
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Telephone | 513-636-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 3341 SOLUTIONS CTR
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City | CHICAGO
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State | IL
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Zip | 60677-3003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT CFO
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Name | MRS. JODIANNE BROOMALL
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Credential |
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Telephone | 513-636-5047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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