| NPI | 1205069424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PETER ORLOUSKY Member Manager 614-342-0243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E-0500159) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 091032) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2009-09-04 |