| Declare Therapy Center Inc | |
|
700 W Pete Rose Way Cincinnati OH 45203-1892 | |
| (513) 290-7908 | |
| (513) 834-7052 |
| Full Name | Declare Therapy Center Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 700 W Pete Rose Way, Cincinnati, Ohio |
| Authorized Official Name and Position | Purcell Taylor (PRESIDENT CEO) |
| Authorized Official Contact | 5132907908 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Declare Therapy Center Inc 700 W Pete Rose Way Ste 456 Cincinnati OH 45203-1875 Ph: (513) 834-7050 | Declare Therapy Center Inc 700 W Pete Rose Way Cincinnati OH 45203-1892 Ph: (513) 290-7908 |
| NPI Number | 1063652527 |
|---|---|
| Provider Enumeration Date | 02/24/2009 |
| Last Update Date | 01/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063652527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 85387 (Ohio) | Secondary |
| 251S00000X | Community/behavioral Health | E0000656, 85387 (Ohio) | Primary |
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