| NPI | 1205382751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JAMES BURGE Administrator 614-443-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2019-08-08 |