Brightview LLC

Organization Active NPI Addiction Medicine (Internal Medicine) Physician · Clarkson, KY

NPI 1053064006 · NPPES record last updated Aug 1, 2023

Key facts

NPI
1053064006
Entity type
Organization (NPI type 2)
Primary specialty
Addiction Medicine (Internal Medicine) Physician 207RA0401X
Legal business name
BRIGHTVIEW LLC
Practice address
625 W Main St
Clarkson, KY 42726-7044
Phone
(833) 510-4357
Fax
(866) 460-2997
NPI assigned
Jan 31, 2022
Organization subpart
Yes
Parent organization (as reported)
BRIGHTVIEW LLC

Authorized official

Name
Amy Marie Nieman
Title
Director
Phone
(513) 544-1003

Corporate family (same tax ID) 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

National Provider Directory

Tax ID family
Brightview LLC (28 organizations share this tax ID)
Part of
Brightview LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RA0401X Yes
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084P0800X
Methadone Clinic 261QM2800X

Addresses

Primary practice location

625 W Main St
Clarkson, KY 42726-7044

Mailing address

4600 Montgomery Rd
Cincinnati, OH 45212-2697
Phone (833) 510-4357

Other providers in Clarkson, KY

All providers in Clarkson, KY · Addiction Medicine (Internal Medicine) Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.