| NPI | 1073496162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN HICKS WATSON Managing Member 614-805-6175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-08-06 |