| NPI | 1063847093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN BENNETT President 740-972-3227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OH 4801325) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |