| NPI | 1699647669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHADIRA NADINE DAVIS-GIST Owner 614-517-9915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2026-09-11 |