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Clean Slate Sober Living, LLC

NPI #1295333052 in Trotwood, Ohio

Provider Information

NPI Number
1295333052
Entity Type
Organization
Organization Name
Clean Slate Sober Living, LLC
Primary Specialty
Non-emergency Medical Transport (VAN)
Enumeration Date
Oct 14, 2020
Last Updated
Oct 14, 2020

Practice Location

Address
714 E MAIN ST
City
Trotwood
State
Ohio
ZIP Code
45426-2909
Phone
(844) 548-7627

Authorized Official

Name
FANNIE WOODS
Title
CREDENTIALING SPECIALIST
Phone
(844) 548-7627

Specialties & Taxonomy Codes

Specialty
Non-emergency Medical Transport (VAN)

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