| NPI | 1639828742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MOLLE Ce O 614-715-3021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2022-11-30 |