Basic Information
Provider Information
NPI: 1467825158
EntityType: 2
ReplacementNPI:  
OrganizationName: BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: GARFIELD SCHOOL BASED HEALTH CENTER
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 HIGH ST FL 4
Address2:  
City: HAMILTON
State: OH
PostalCode: 450116078
CountryCode: US
TelephoneNumber: 5134541460
FaxNumber:  
Practice Location
Address1: 250 N FAIR AVE
Address2:  
City: HAMILTON
State: OH
PostalCode: 450114222
CountryCode: US
TelephoneNumber: 5134541460
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/04/2015
LastUpdateDate: 08/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BELDEN
AuthorizedOfficialFirstName: JULIA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 5134541468
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/18/2021

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

No ID Information.


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