| NPI | 1013626159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEEYANNA CROCKETT Owner 614-927-9325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 174200000X | |
| 177F00000X Lodging | |
| 251S00000X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2022-12-16 |