Basic Information
Provider Information
NPI: 1154347789
EntityType: 2
ReplacementNPI:  
OrganizationName: THE HEALTHCARE CONNECTION, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MT. HEALTHY FAMILY PRACTICE CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1411 COMPTON RD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452313559
CountryCode: US
TelephoneNumber: 5135227500
FaxNumber: 5137284064
Practice Location
Address1: 1411 COMPTON RD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452313559
CountryCode: US
TelephoneNumber: 5135227500
FaxNumber: 5137284064
Other Information
ProviderEnumerationDate: 07/15/2006
LastUpdateDate: 08/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LINDSAY
AuthorizedOfficialFirstName: DOLORES
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 5134833080
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400X  Y Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

ID Information
IDTypeStateIssuerDescription
082636005OH MEDICAID


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