| NPI | 1689340523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN SIMMONS Owner 740-249-8061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2022-01-06 |