MEDICARE: GREATER CINCINNATI BEHAVIORAL HEALTH SERVICES

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588626097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER CINCINNATI BEHAVIORAL HEALTH SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 6296
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-6296
Country	:	US
Telephone Number	:	513-354-7000
Fax Number	:	513-354-7115

Provider Business Practice Location Address
First Line	:	1501 MADISON RD
Second Line	:
City	:	WALNUT HILLS
State	:	OH
Zip	:	45206-1706
Country	:	US
Telephone Number	:	513-354-7000
Fax Number	:	513-354-7115

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. JEFF O'NEIL
Credential	:	MED, LPCC
Telephone Number	:	513-354-7001

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	05/05/2014

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