| NPI | 1235881210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FABIAN GLEN ROSEL Clinical Director 740-314-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2023-09-25 |