| Jason Groves, CDCA | |
|
288 W Aberdeen Dr, Trenton, OH 45067-1175 | |
| (513) 465-2885 | |
| Not Available |
| Full Name | Jason Groves |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 288 W Aberdeen Dr, Trenton, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376166249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | CDCA.188843 (Ohio) | Primary |
| Entity Name | Cleanslate Medical Group Of Ohio Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558800193 PECOS PAC ID: 9537418025 Enrollment ID: O20190108003833 |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Groves, CDCA 288 W Aberdeen Dr, Trenton, OH 45067-1175 Ph: (513) 465-2885 | Jason Groves, CDCA 288 W Aberdeen Dr, Trenton, OH 45067-1175 Ph: (513) 465-2885 |
Mckenzie Jane Kyde, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 113 3rd St, Trenton, OH 45067 Phone: 513-500-5225 | |
Teresa Nichols, Counselor Medicare: Not Enrolled in Medicare Practice Location: 819 Harbor Pl, Trenton, OH 45067 Phone: 513-907-0120 | |
Samantha Joy Hinds, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3500 Busenbark Rd, Trenton, OH 45067 Phone: 937-219-7770 |