South Community Inc. | |
3095 Kettering Blvd Moraine OH 45439-1983 | |
(937) 293-8300 | |
Not Available |
Full Name | South Community Inc. |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 3095 Kettering Blvd, Moraine, Ohio |
Authorized Official Name and Position | Lisa Carter (CEO) |
Authorized Official Contact | 9372938300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
South Community Inc. 3095 Kettering Blvd Moraine OH 45439-1983 Ph: (937) 293-8300 | South Community Inc. 3095 Kettering Blvd Moraine OH 45439-1983 Ph: (937) 293-8300 |
NPI Number | 1689932626 |
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Provider Enumeration Date | 04/27/2012 |
Last Update Date | 05/31/2023 |
Certification Date | 05/31/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689932626 | NPI | - | NPPES |
0320870 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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