| Pax Treatment Centers Llc | |
|
4302 Roosevelt Blvd Middletown OH 45044-6625 | |
| (513) 433-1032 | |
| (513) 433-1245 |
| Full Name | Pax Treatment Centers Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 4302 Roosevelt Blvd, Middletown, Ohio |
| Authorized Official Name and Position | Angie Newman (BILLING MANAGER) |
| Authorized Official Contact | 3375822034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pax Treatment Centers Llc 4302 Roosevelt Blvd Middletown OH 45044-6625 Ph: (513) 433-1032 | Pax Treatment Centers Llc 4302 Roosevelt Blvd Middletown OH 45044-6625 Ph: (513) 433-1032 |
| NPI Number | 1609351477 |
|---|---|
| Provider Enumeration Date | 09/27/2018 |
| Last Update Date | 03/25/2020 |
| Certification Date | 03/25/2020 |
| Medicare PECOS PAC ID | 9133460983 |
|---|---|
| Medicare Enrollment ID | O20190404002312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609351477 | NPI | - | NPPES |
| Provider Name | James R Chaillet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174561310 PECOS PAC ID: 7911806740 Enrollment ID: I20031231000247 |
| Provider Name | Robert B Sorscher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750349163 PECOS PAC ID: 5395704506 Enrollment ID: I20041005000071 |
| Provider Name | Mary Leyendecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417322397 PECOS PAC ID: 3173826559 Enrollment ID: I20160119000664 |
| Provider Name | Clifford Q Cabansag |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1003065905 PECOS PAC ID: 8224276928 Enrollment ID: I20170725002789 |
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