| NPI | 1699254300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARMAINE C HOLBROOK Finance Coordinator 740-532-3767 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OH 12344) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |