| NPI | 1649042185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY MCELVEEN COO 614-813-0991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2025-02-27 |