| NPI | 1538623368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE MYRICK CEO 614-980-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2022-11-13 |