| NPI | 1518379296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY C MOHR Director / Odrc 614-752-1164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH 001345) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |