| NPI | 1730792524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETISHA E LEACH Cnp 614-809-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2022-03-29 |