| NPI | 1154691483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEREZ E EDMONDS Operations Manager 614-216-8980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6801088243) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-03-20 |