| NPI | 1033808324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA WISEMAN Owner 740-466-4103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2023-05-03 |