| NPI | 1285188078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ANN JACKSON Program Coordinator 614-620-2284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH 131049) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |