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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CLEANSLATE MEDICAL GROUP OF OHIO LLC

Active Organization

CLEANSLATE MEDICAL GROUP OF OHIO LLC is a Addiction Medicine (Internal Medicine) organization located in MORAINE, Ohio. NPI 1558800193 is currently active in the NPPES registry. Verify at CMS.

Addiction Medicine (Internal Medicine) · MORAINE, OH

Registration Details

NPI Number
1558800193
Provider Type
Organization
NPI Issued
Feb 15, 2017 (9.5399768552449 yrs)
Last Updated
Dec 17, 2025

Practice Information

Address
4700 SPRINGBORO PIKE STE C
MORAINE, OH, 454391982
Browse OH providers · Browse ZIP 45439
Phone
9375585100
Fax
8332797074
Primary Specialty
Addiction Medicine (Internal Medicine)
207RA0401X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.