| NPI | 1033213509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY DANYELLE VANCE Independent Living Services Provide 740-244-3309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: OH 266764) |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2020-08-22 |