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NPI Code Detail

MEDICARE: JEFFREY HOGLUND CDCA II

MEDICARE: JEFFREY HOGLUND CDCA II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1538670922
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY HOGLUND CDCA II
Provider Business Mailing Address
First Line : 6814 BRYN MAWR DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45224-1723
Country : US
Telephone Number : 937-813-1737
Fax Number :
Provider Business Practice Location Address
First Line : 1 ELIZABETH PL
Second Line :
City : DAYTON
State : OH
Zip : 45417-3445
Country : US
Telephone Number : 937-813-1737
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2017
Last Update Date : 10/12/2017

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