| NPI | 1689922940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JEAN COLEMAN Independent Provider 614-449-2491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 251S00000X Community/Behavioral Health | |
| 251X00000X Supports Brokerage | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-08-16 |