| NPI | 1508617382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB TIMOTHY ELLZEY Executive Director 614-498-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-03-29 |
| Last Update Date | 2024-03-29 |