| NPI | 1407234487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L PAYNE Owner/Director 614-843-1696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |