| NPI | 1003480542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER TABER Program Director 614-665-0665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2023-11-29 |