| NPI | 1043433113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A BRYAN Indepant Provider 740-382-5425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |