Provider Demographics
NPI:1568270676
Name:NAFRESHA ABUAUN PRIVATE PRACTICE LLC
Entity type:Organization
Organization Name:NAFRESHA ABUAUN PRIVATE PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAFRESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-835-4901
Mailing Address - Street 1:17 STANTON DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-8632
Mailing Address - Country:US
Mailing Address - Phone:937-835-4901
Mailing Address - Fax:937-848-1535
Practice Address - Street 1:2555 S DIXIE DR STE 201
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-1532
Practice Address - Country:US
Practice Address - Phone:937-835-4901
Practice Address - Fax:937-848-1535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder