Provider Demographics
NPI:1992553325
Name:MCALISTER, JESSE
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:MCALISTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 KINNETT RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:OH
Mailing Address - Zip Code:45106-7204
Mailing Address - Country:US
Mailing Address - Phone:513-708-4125
Mailing Address - Fax:
Practice Address - Street 1:2950 KINNETT RD
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:OH
Practice Address - Zip Code:45106-7204
Practice Address - Country:US
Practice Address - Phone:513-708-4125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities