| NPI | 1730702333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JOHNSON Administrator 614-717-0822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2022-11-14 |