MEDICARE: CINCINNATI HEALING ARTS LLC

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	302R00000X	Health Maintenance Organization	5095	KY
2	302R00000X	Health Maintenance Organization	3869	OH

General Provider Information

NPI Number	:	1821326273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATI HEALING ARTS LLC

Provider Business Mailing Address
First Line	:	215 CLINTON SPRINGS AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45217-1905
Country	:	US
Telephone Number	:	513-252-8043
Fax Number	:	513-514-8856

Provider Business Practice Location Address
First Line	:	215 CLINTON SPRINGS AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45217-1905
Country	:	US
Telephone Number	:	513-252-8043
Fax Number	:

Authorized Official
Title or Position	:	DR. MADDOX
Name	:	DR. JAMILA KIANGA MADDOX
Credential	:	D.C.
Telephone Number	:	513-376-3996

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	10/28/2024

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