| NPI | 1639856651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ULRIKE JENNIFER ERIKA MARTIN Owner/Operator 740-330-4310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2024-07-24 |