| NPI | 1538733076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL FULLER Interim Director 614-302-9515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2021-09-09 |