Provider Demographics
NPI:1366157430
Name:NORTHMONT BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:NORTHMONT BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:THORN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:937-239-6967
Mailing Address - Street 1:8529 N DIXIE DR STE 350
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-2476
Mailing Address - Country:US
Mailing Address - Phone:937-267-1523
Mailing Address - Fax:937-999-4216
Practice Address - Street 1:8529 N DIXIE DR STE 350
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2476
Practice Address - Country:US
Practice Address - Phone:937-267-1523
Practice Address - Fax:937-999-4216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHMONT BEHAVIORAL HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-23
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty