Organization
ANANSI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH VUKASINOVICH (MANAGER)
(937) 672-1424
Entity
Organization
Contact information
Practice address
201 W FRANKLIN ST STE B, CENTERVILLE, OH 45459-4700
(937) 672-1424
Mailing address
201 W FRANKLIN ST STE B, CENTERVILLE, OH 45459-4700
(937) 672-1424
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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