| NPI | 1518649995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SA'JAE EVERHART Owner 614-290-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2023-08-03 |