| NPI | 1285482422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOREDE OLA Director 614-974-4182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-13 |