MEDICARE: ANDIAMO HEALTHCARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	320800000X	Mental Illness Community Based Residential Treatment Facility
2	363L00000X	Nurse Practitioner
3	261QM0850X	Adult Mental Health Clinic/Center
4	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1568161420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDIAMO HEALTHCARE

Provider Business Mailing Address
First Line	:	5710 STONE LAKE DR
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45429-6053
Country	:	US
Telephone Number	:	330-329-7980
Fax Number	:

Provider Business Practice Location Address
First Line	:	6210 BELLEFONTAINE RD
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-4009
Country	:	US
Telephone Number	:	330-329-7980
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. ANGELA M PALITTO
Credential	:	DO
Telephone Number	:	330-329-7980

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	12/18/2023

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Directions to “ANDIAMO HEALTHCARE ” Practice Location

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