| NPI | 1124436654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE ELLIS Owner 740-974-5832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2015-02-23 |