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General NPI Number Information
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NPI Number | 1831906759
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Entity Type | Organization
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Legal Business Name | TOTAL MIND AND RECOVERY LLC
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 78 N BREIEL BLVD
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City | MIDDLETOWN
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State | OH
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Zip | 45042-3804
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Country | US
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Telephone | 513-465-2885
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Fax |
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Provider Business Mailing Address
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Address Line | 288 W ABERDEEN DR
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City | TRENTON
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State | OH
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Zip | 45067-1175
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Country | US
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Telephone | 513-465-2885
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JASON GROVES
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Credential | CDCA
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Telephone | 513-465-2885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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