| NPI | 1457330938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEA LYNN DODSON Assistant Director 740-342-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2019-02-28 |