| NPI | 1174201545 |
|---|---|
| Doing Business As | PROFESSIONAL BEHAVIORAL SUPPORT LLC |
| Entity Type | Organization |
| Authorized Contact | ELIETH KOKWESIGA KAMALA Pschiatric Nurse Practictitioner 614-574-1823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2023-12-09 |