| NPI | 1366969909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GOR CEO 614-300-5878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2024-09-23 |