| NPI | 1649092974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON FAIR Administrator 614-648-9768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-11-06 |