| NPI | 1659148641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY COTTERMAN Director Of Operations 614-210-0944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-12-08 |
| Last Update Date | 2023-12-08 |