Organization
SELFREFIND OHIO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES DURHAM (PRESIDENT)
(859) 209-2287
Entity
Organization
Contact information
Practice address
4312 OLD SCIOTO TRL, PORTSMOUTH, OH 45662-6642
(740) 961-5005
Mailing address
461 S 4TH ST, DANVILLE, KY 40422-2053
(859) 209-2287
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
13822
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13822
—
OH
Enumeration date
07/01/2015
Last updated
07/16/2015
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