| NPI | 1306248380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLIN JENSEN Speech Language Pathologist 614-570-1143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: OH OH3205097) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OH OH3205097) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2014-09-29 |