| NPI | 1093350951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBENEZER ALUMA Agent 614-364-0429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2025-01-08 |