| NPI | 1699553404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR WHITE Owner 614-578-0958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2025-01-08 |