| NPI | 1750250494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWAIN GORDON JR Managing Member 614-946-5504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Additional Taxonomies | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities |
| Enumeration Date | 2025-10-31 |
| Last Update Date | 2025-10-31 |