| NPI | 1568822633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY SMITH Program Director 740-442-7875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2021-10-19 |