| NPI | 1144939588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE MYRICK Owner 614-980-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 253J00000X Foster Care Agency | |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 273R00000X Psychiatric Unit | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 385H00000X Respite Care | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2022-11-22 |