| NPI | 1275082851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE DIXSON Administrator 614-602-7614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 10719742#2NJ62) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |