| NPI | 1104214048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALISA DAWN PETERS Clinical Case Manager 614-253-8050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OH S.1450587) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |