| NPI | 1023982592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE HEBERT Authorized Official 614-705-0504 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-10-06 |