| NPI | 1124603394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE MYRICK President 614-980-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| 251S00000X | |
| 253J00000X Foster Care Agency | |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-03-10 |