| NPI | 1205714599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE B HICKMAN Contracting & Credentialing Manager 614-844-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |